title: Sonication as a diagnostic approach used to investigate the infectious etiology of prosthetic hip joint loosening.
abstract: The purpose of the study was to evaluate the usefulness of sonication for the diagnosis of prosthetic joint infections (PJIs) by its comparison with periprosthetic tissues (PTs) and synovial fluid (SV-F) cultures. The study groups included 54 patients undergoing exchange of total hip prostheses for so called "aseptic" loosening occurring without clinical manifestations of an accompanying PJI and 22 patients who developed a sinus tract communicating with the prosthesis which was indicative of an ongoing infectious process. Significant positive culture results were obtained among 10 (18.5%) patients with "aseptic" implant failure and in 18 (81.8%) patients who developed a sinus tract. Sonicate-fluid (S-F) yielded bacterial growth in all culture-positive patients with "aseptic" loosening vs. 15 patients with presumed PJIs. There was a concordance in terms of bacterial species isolated from S-F and conventional cultures from individual patients. Coagulase-negative staphylococci were isolated most frequently. Sensitivity of sonication (75%) exceeded that estimated for PTs (69%) and SV-F (45%) cultures. We conclude that identification of causative agents of PJIs which is critical to further therapeutic decisions is aided by the combination of sonication and conventional culture.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Bogut
authors.forename: Justyna
authors.initials: J
authors.lastname: Niedźwiadek
authors.forename: Maria
authors.initials: M
authors.lastname: Kozioł-Montewka
authors.forename: Dagmara
authors.initials: D
authors.lastname: Strzelec-Nowak
authors.forename: Jan
authors.initials: J
authors.lastname: Blacha
authors.forename: Tomasz
authors.initials: T
authors.lastname: Mazurkiewicz
authors.forename: Julia
authors.initials: J
authors.lastname: Macias
authors.forename: Wojciech
authors.initials: W
authors.lastname: Marczyński
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001431:Bacteriological Techniques / Q000379:methods*; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014463:Ultrasonography