Heraeus MicroDTTect Lyon Pilot Studyprosthetic Joint Infections (PJIs)

Prosthetic joint infections (PJIs) are one of the main causes of implant failure after joint arthroplasty. Identification of the causal organism is crucial for successful treatment. However, microbiological diagnosis of PJIs remains a challenge notably because bacteria are embedded in biofilm adhered to the material. Recently, dithiothreitol (DTT) treatment of prosthesis has been proposed as a new strategy to dislodge bacteria from biofilm, thus becoming an alternative to sonication to improve the yield of the microbiological diagnosis.

In this study, the investigators evaluate the interest of a commercial device using DTT, the MicroDTTect system (Heraeus, Hanau, Allemagne), for the diagnosis of low-grade chronic PJIs compared to the conventional culture of periprosthetic tissue (PPT) samples.

Inclusion criteria

Adult patients with painful prosthesis or prosthesis loosening <10 years

• without mechanical explanation,
• without clinical evidence of infection (no fistula, no abscess, no discharge, no local inflammation),
• without microbiological diagnosis (absence of preoperative joint puncture (not performed or not feasible) or with a culture-negative preoperative joint puncture).

Exclusion criteria

Patients with painful prosthesis or prosthesis loosening

• with mechanical explanation,
• or with clinical evidence of infection (fistula, abscess, discharge, local inflammation),
• with a previous microbiological diagnosis