{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T03:02:30Z","timestamp":1779678150737,"version":"3.53.1"},"reference-count":32,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Prosthetic joint infection following total knee arthroplasty remains a significant public health challenge. Automated surveillance systems are increasingly used for national monitoring of surgical site infections after arthroplasty. This study assessed the performance of the French ISO-ORTHO automated surveillance indicator after primary total knee arthroplasty by comparing automated surveillance data with exhaustive clinical follow-up. It also reported the incidence of surgical site infections during the initial years of activity of a tertiary care university hospital. Methods: A retrospective cohort analysis of primary total knee arthroplasties performed between January 2016 and December 2018 was conducted using exhaustive clinical chart review and the French ISO-ORTHO automated surveillance system. Prosthetic joint infections were diagnosed according to the 2018 International Consensus Meeting criteria. The local ISO-ORTHO results were compared with the national ISO-ORTHO rates. Results: Clinical chart review identified 1138 primary total knee arthroplasties and five prosthetic joint infections. Prosthetic joint infection incidence was 0.44% with a mean follow-up of 40.5 months. ISO-ORTHO was not yet implemented in 2016. Between 2017 and 2018, ISO-ORTHO identified 519 procedures and one prosthetic joint infection, compared with 807 procedures and three infections identified by clinical review. Conclusions: The French ISO-ORTHO surveillance indicator aided local and national monitoring of surgical site infections after total knee arthroplasty, but discrepancies with clinical chart review highlighted important limitations of automated monitoring and the importance of prolonged clinical follow-up. Future surveillance strategies could integrate these complementary approaches to improve prosthetic joint infection detection.<\/jats:p>","DOI":"10.3390\/jcm15114047","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T01:45:08Z","timestamp":1779673508000},"page":"4047","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Site Infections After Primary Total Knee Arthroplasty: A Retrospective Cohort Study and Critical Assessment of the French ISO-ORTHO Surveillance Indicator"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4172-3040","authenticated-orcid":false,"given":"Alessander","family":"D\u2019Ascoli","sequence":"first","affiliation":[{"name":"Centre National de la Recherche Scientifique (CNRS), Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), UMR 7052, U1271, Universit\u00e9 Paris Cit\u00e9, B3OA, 75010 Paris, France"},{"name":"Service de Chirurgie Orthop\u00e9dique, AP-HP, H\u00f4pital Cochin, 75014 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9971-9213","authenticated-orcid":false,"given":"Jean-Luc","family":"Raynier","sequence":"additional","affiliation":[{"name":"Instutut de Chirurgie R\u00e9paratrice Locomoteur et Sports de l\u2019Institut Mon\u00e9gasque de M\u00e9decine du Sport (ICR IM2S), 11 Avenue d\u2019Ostende, 98000 Monaco, Monaco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Courjon","sequence":"additional","affiliation":[{"name":"Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-Universitaire de Nice, H\u00f4pital l\u2019Archet 1, 151 Route de Saint Antoine de Ginesti\u00e8re, 06202 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmina","family":"Berrouane","sequence":"additional","affiliation":[{"name":"Service d\u2019Hygi\u00e8ne Hospitali\u00e8re, Centre Hospitalo-Universitaire de Nice, H\u00f4pital Cimiez, 4 Avenue Reine Victoria, 06003 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Boileau","sequence":"additional","affiliation":[{"name":"Institut de Chirurgie R\u00e9paratrice Locomoteur et Sports (ICR Nice), 9 Avenue Durante, 06000 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Trojani","sequence":"additional","affiliation":[{"name":"Instutut de Chirurgie R\u00e9paratrice Locomoteur et Sports de l\u2019Institut Mon\u00e9gasque de M\u00e9decine du Sport (ICR IM2S), 11 Avenue d\u2019Ostende, 98000 Monaco, Monaco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.2106\/JBJS.17.01617","article-title":"Projected Volume of Primary Total Joint Arthroplasty in the U.S., 2014 to 2030","volume":"100","author":"Sloan","year":"2018","journal-title":"J. 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