title: Evaluation of sonicate fluid cultures in comparison to histological analysis of the periprosthetic membrane for the detection of periprosthetic joint infection.
abstract: OBJECTIVE
  The aim of this prospective study was to evaluate the diagnostic efficacy of sonicate fluid cultures (SFC) and the histological analysis of the periprosthetic membrane (PM) for the detection of periprosthetic joint infection (PJI).
  
  
  METHODS
  The histological samples were evaluated according to the consensus classification of PM as defined by Morawietz and Krenn. All explanted endoprosthesis were subject to sonication. Additionally, a synovial aspiration and microbiological culture of tissue samples were performed for each patient. Twenty three of the 59 patients had an established PJI.
  
  
  RESULTS
  Sonication achieved the highest sensitivity out of all diagnostic methods with 91 % and a specificity of 81 %. The PM achieved a sensitivity of 87 % and a specificity of 100 %. In three cases of PJI a pathogen was isolated solely by sonication while all other microbiological methods were negative. In seven cases there was a positive bacterial culture through sonication with negative histology.
  
  
  CONCLUSIONS
  Our results show a high correlation between the microbiological and histological results. In our patient group sonication achieved the highest sensitivity out of all diagnostic methods and was more sensitive than conventional microbiological methods.
authors.affiliation: Orthopaedic Department, Center for Musculoskeletal Surgery, Charité - Universitätsmedizin, Charitéplatz 1, 10117, Berlin, Germany. Viktor.Janz@Charite.de
authors.forename: Viktor
authors.initials: V
authors.lastname: Janz
authors.forename: Georgi I
authors.initials: GI
authors.lastname: Wassilew
authors.forename: Olaf
authors.initials: O
authors.lastname: Hasart
authors.forename: Georg
authors.initials: G
authors.lastname: Matziolis
authors.forename: Stephan
authors.initials: S
authors.lastname: Tohtz
authors.forename: Carsten
authors.initials: C
authors.lastname: Perka
mesh_terms: D000368:Aged; D001419:Bacteria / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D001431:Bacteriological Techniques; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D007595:Joint Prosthesis / Q000382:microbiology*; D007596:Joints / Q000473:pathology; D008297:Male; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000382:microbiology; D012680:Sensitivity and Specificity; D013010:Sonication; D013583:Synovial Membrane / Q000382:microbiology / Q000473:pathology*