{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:22Z","timestamp":1787755582628,"version":"build-2784847793"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2019,10,16]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Infections complicate a minority of orthopaedic arthroplasties but are the leading cause of malpractice claims. The basis for the claims is unclear. The objective of this study was to identify the main deviations from current recommendations by reviewing patient files recorded by a major French medical liability-specialized insurance company for private practitioners (MACSF [Mutuelle d\u2019Assurance du Corps de Sant\u00e9 Fran\u00e7ais]) and to analyze legal claims and outcomes of litigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All claims data for periprosthetic joint infections were analyzed retrospectively from 2010 to 2014. Treatment strategies were compared with therapeutic guidelines published by medical societies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Forty-five claims for periprosthetic joint infection were recorded; 82% of patients were men and the mean patient age was 63 years. Twenty-one patients (47%) had a knee arthroplasty, 21 had a hip arthroplasty, 2 had a shoulder arthroplasty, and 1 had an ankle arthroplasty. Twenty-three infections (51%) occurred within 1 month postoperatively.\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      was isolated from intraoperative samples in 36% of the cases (including 25% of these with methicillin-resistant strains), and coagulase-negative staphylococci were isolated in 51% (44% methicillin-resistant strains) of the cases. Treatment lasted for a median of 9.5 months (range, 1.5 to 96 months), with a median of 6 months (range, 1.5 to 20 months) of antibiotics and 3 surgical procedures (range, 0 to 7 surgical procedures). A total of 18% of patients had antibiotic-related side effects, 2% of patients died, and 76% of patients had persistent sequelae. An infectious disease specialist\u2019s advice was required for 56% of the patients. Discordances with therapeutic guidelines were found in 76% of the patient files, including delay in diagnosis (44%) and inadequate medical treatment (18%) or medico-surgical treatment (13%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Late diagnosis of early postoperative infections appears to be the major cause of inappropriate management and malpractice litigation. Discordance with current guidelines was identified. Early consultation with an infectious disease specialist may help to reduce malpractice claims.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.19.00101","type":"journal-article","created":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T06:17:32Z","timestamp":1571293052000},"page":"1806-1811","source":"Crossref","is-referenced-by-count":19,"title":["Reasons for Litigation in Arthroplasty Infections and Lessons Learned"],"prefix":"10.2106","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5209-3806","authenticated-orcid":false,"given":"Olivia","family":"Senard","sequence":"first","affiliation":[{"name":"D\u00e9partement de Maladies Infectieuses, H\u00f4pital Raymond Poincar\u00e9, AP-HP, Universit\u00e9 de Versailles, Versailles, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7286-587X","authenticated-orcid":false,"given":"Thierry","family":"Houselstein","sequence":"additional","affiliation":[{"name":"Mutuelle d\u2019Assurance du Corps de Sant\u00e9 Fran\u00e7ais (MACSF), La D\u00e9fense, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5799-6003","authenticated-orcid":false,"given":"Anne-Claude","family":"Cr\u00e9mieux","sequence":"additional","affiliation":[{"name":"Service de Maladies Infectieuses, H\u00f4pital Saint Louis, AP-HP, Universit\u00e9 Paris 7, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"4","key":"bib1-20230811","doi-asserted-by":"crossref","first-page":"780","DOI":"10.2106\/00004623-200704000-00012","article-title":"Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030","volume":"89","author":"Kurtz","year":"2007","journal-title":"J Bone Joint Surg Am."},{"issue":"8","key":"bib2-20230811","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.arth.2012.02.022","article-title":"Economic burden of periprosthetic joint infection in the United States","volume":"27","author":"Kurtz","year":"2012","journal-title":"J Arthroplasty."},{"issue":"8","key":"bib3-20230811","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.ajic.2004.10.001","article-title":"National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1992 through June 2004, issued October 2004","volume":"32","year":"2004","journal-title":"Am J Infect Control."},{"key":"bib4-20230811","author":"Tanguy","year":"2018","journal-title":"R\u00e9seau d\u2019alerte, d\u2019investigation et de surveillance des infections nosocomiales (RAISIN). 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