Increased rate of bacterial colonization on PE-components in total joint arthroplasty: An evaluation through sonication.
BACKGROUND
It is currently unclear if an isolated exchange of the mobile components, in cases of periprosthetic joint infection (PJI), leads to a complete eradication of all bacteria or if residual bacteria remain attached to the retained components?


OBJECTIVE
The purpose of this study was to investigate if bacteria only adhere to certain components or materials, or if they are ubiquitously distributed throughout the joint.


METHODS
Twenty hundred and eighty four patients undergoing revision total hip or total knee arthroplasty surgery were included in this retrospective cohort study. Synovial fluid cultures, periprosthetic tissue cultures, histological samples and sonicate fluid cultures (SFC) from the individual endoprosthetic components were acquired. The isolated bacterial species were recorded according to their endoprosthetic component of origin.


RESULTS
In 72% of all cases with multiple SFC, the cultures were concordant with all samples being either homogenously negative or showing positive bacterial growth. The polyethylene (PE) components showed a significantly higher rate of bacterial isolation than the non-mobile components. All components and materials showed bacterial colonization, however between all other components or materials were not statistically significant.


CONCLUSIONS
PE-components show a higher rate of bacterial isolation than other components. If an isolated bearing exchange is performed this should be supplemented by adequate antimicrobial therapy.
Viktor
V
Janz
Georgi I
GI
Wassilew
Carsten F
CF
Perka
Benjamin
B
Bartek
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D006801:Humans; D008422:Materials Testing; D020959:Polyethylene; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D012086:Reoperation; D012189:Retrospective Studies; D013010:Sonication / Q000379:methods*; D013582:Synovial Fluid / Q000382:microbiology
D020959:Polyethylene
PJI; Sonication; bacterial colonization; endoprosthetic components; total joint arthroplasty