Diagnostic et traitement des infections d'implants orthopédiques [Update on implant related infections in orthopaedic surgery. Diagnosis and treatment]

Infections associated with implants are increasingly important in modem medicine. Biofilms are the cause that these infections are more difficult to diagnose and to cure. Particularly low-grade infections are difficult to distinguish from aseptic failure, because they often present with early loosening and persisting pain. For an accurate diagnosis, clinical signs and symptoms, laboratory markers of infection, microbiology, histology and imaging examinations are needed. The treatment goal is eradication of infection and an optimal functional result. Successful treatment requires adequate surgical procedure combined with long-term antimicrobial therapy, ideally with an agent acting on biofilms.

Fractures périprothétiques [Periprosthetic fractures]

A periprosthetic fracture is a fracture around or in proximity of a prosthetic implant. As more and more prostheses are implanted, the incidence of periprosthetic fractures also increases. Several risk factors have been outlined, some due to the patient, and some due to the implant itself. Key points in diagnosis are the case history and the imaging, as they allow the distinction between a well-fixed and a loose prosthesis. Correct classification is crucial for the treatment choice, which can be non-operative or consist in an osteosynthesis or in a revision arthroplasty, depending on the patient's general medical condition and the local status.