[Bone and joint prosthesis infections].
Despite the advances made in the surgical management and the optimization of anti-infective treatments, bacterial infections on bone and joint prosthesis remain a diagnostic and especially therapeutic issue. Infections can be either early (postoperative) or late (hematogenous) acute infections, or late chronic infections. Typically, the diagnosis of hematogenous acute infections is usually easy to establish. However, diagnosing chronic infections is more complex and mostly requires complementary examinations. In any case, no element can indicate with certainty the existence of an infection, aside from the identification of germs in the samples, properly collected. Treatment combines one of the various surgical strategies (surgical scrub with prosthesis maintenance, 1- or 2-step prosthesis replacement, prosthesis removal without reimplantation or head-neck resection, therapeutic abstention) and an extended antibiotherapy. In any scenario, a close collaboration between physicians and surgeons is essential to stop the infectious process.
Bernard
Louis
L
Service de maladies infectieuses, hôpital Raymond-Poincaré, UVSQ, 92380 Garches. louis.bernard@rpc.aphp.fr
Boisrenoult
Philippe
P
Besnier
Jean-Marc
JM
Beaufils
Philippe
P
Arvieux
Cédric
C
D001847:Bone Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000503:physiopathology / Q000628:therapy; D003663:Decision Trees; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000503:physiopathology / Q000628:therapy; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy