Sonicating Explanted Prosthetic Joints Helps Detect Infection

Culture of samples obtained by sonication are more sensitive for microbial infection than tissue culture

WEDNESDAY, Aug. 15 (HealthDay News) -- Sonicating explanted hip and knee prostheses to dislodge bacterial biofilms can detect infections better than standard tissue culture, according to the results of a study published in the Aug. 16 issue of the New England Journal of Medicine.

Andrej Trampuz, M.D., of the Mayo Clinic College of Medicine in Rochester, Minn., and colleagues conducted a prospective trial comparing cultures obtained by sonication versus standard techniques. The trial included 331 patients who underwent removal of hip or knee prostheses for aseptic failure or prosthetic-joint infection.

The sensitivity of sonicate-fluid culture for diagnosis of microbial infection was superior to that of periprosthetic tissue culture (78.5 percent versus 60.8 percent). The specificities of sonicate-fluid culture and tissue culture were 98.8 percent and 99.2 percent, respectively. In patients who received antibiotics within 14 days prior to surgery, the sonicate fluid-culture was more sensitive than tissue culture (75 percent versus 45 percent).

"The results of our study show that culture of microorganisms from removed orthopedic implants is more sensitive than tissue culture," the authors conclude. "Given the limitations of the current microbiologic techniques for identifying the organisms that cause prosthetic-joint infection, this new technique warrants further study."

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