engleski

Sonication in periprostethic joint infections diagnostics

Periprosthetic joint infections (PJI) after arthroplasty are not frequent, but they represent complications associated with high morbidity. Usually there is a need for additional surgery, long and expensive antibiotic treatment and implantation of a new prostethic joint. Therefore a need for a precise diagnosis of PJI is important for the treatment success. The aim of this study was to compare results of standard microbiological processing of periprosthetic tissue samples and sonication of extracted implants in diagnosing periprosthetic infection. Method: During the one year period (July 1st 2018 till June 30th 2019) in the Ortophaedic Clinic Lovran, Croatia, altogether 72 patients were operated and treated because of suspected PJI. In all patients tissue samples were taken for microbiological analysis, and the metal parts of prosthesis were sent to sonication. The sonication fluid for microbiological analysis was collected using ultrasonic water bath BactoSonic®, Bandelin GmbH, Berlin. Results: Out of the 72 patients treated, a microorganism was isolated in 46 patients and the diagnosis of periprosthetic infection was confirmed. In 82% of patients were positive tissue cultures, while sonication fluid cultures were positive in 89% of patients. Where both tissue cultures and sonication fluid cultures were positive, in 12 cases a different or additional microorganism was cultured using sonication. Conclusions: Sonication has become an essential diagnostic tool in the diagnosis of PJI. Sonication enabled the detection of a microorganism which had caused infection also in the cases where only mechanical loosening had been suspected and thus further therapeutic procedures and treatment of these patients were improved.

sonication ; periprosthetic joint infection, diagnostics

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