Sonication: a valuable technique for diagnosis and treatment of periprosthetic joint infections.
BACKGROUND
Periprosthetic joint infection (PJI) is the most severe complication, following joint arthroplasty. Identification of the causal microbial factor is of paramount importance for the successful treatment.


OBJECTIVE
The aim of this study is to compare the sonication fluid cultures derived from joint prosthetic components with the respective periprosthetic tissue cultures.


METHODS
Explanted prosthesis components for suspected infection were placed into a tank containing sterile Ringer's solution and sonicated for 1 minute at 40 kHz. Sonication fluid cultures were examined for 10 days, and the number and identity of any colony morphology was recorded. In addition, periprosthetic tissue specimens (>5) were collected and cultured according to standard practice. The duration of antimicrobial interruption interval before culture sampling was recorded.


RESULTS
Thirty-four patients composed the study group. Sonication fluid cultures were positive in 24 patients (70.5%). Sixteen of thirty four periprosthetic tissue cultures (47.1%) were considered positive, all revealing the same microbial species with the respective sonication fluid cultures: 3 tissue samples showed polymicrobial infection. All tissue cultures were also found positive by the sonication fluid culture.


CONCLUSIONS
Sonication fluid cultures represent a cheap, easy, accurate, and sensitive diagnostic modality demonstrating increased sensitivity compared to periprosthetic tissue cultures (70.5 versus 47.1%).
3rd Department of Orthopaedic Surgery, University of Athens, KAT Hospital, Nikis 2 Street, 14561 Athens, Greece.
D S
DS
Evangelopoulos
I P
IP
Stathopoulos
G P
GP
Morassi
S
S
Koufos
A
A
Albarni
P K
PK
Karampinas
A
A
Stylianakis
S
S
Kohl
S
S
Pneumaticos
J
J
Vlamis
D000368:Aged; D000369:Aged, 80 and over; D018441:Biofilms / Q000528:radiation effects*; D002176:Candida albicans / Q000472:pathogenicity / Q000502:physiology; D004926:Escherichia coli / Q000472:pathogenicity / Q000502:physiology; D005260:Female; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000628:therapy; D011511:Proteus / Q000472:pathogenicity / Q000502:physiology; D011549:Pseudomonas / Q000472:pathogenicity / Q000502:physiology; D013010:Sonication / Q000379:methods*; D013210:Staphylococcus / Q000472:pathogenicity / Q000502:physiology