Anastasios Gketsos,Antonios Kardatos,Antonios Stylianakis,Ioannis Giannaris,Nikolaos Baxevanos,Nikolaos Liarakos,Panagiotis Lepetsos,
Patient-Related Factors Affecting the Sensitivity of Sonication of Removed Hip and Knee Implants Against Conventional Tissue Cultures for Diagnosis of Prosthetic Joint Infections
Clinical Microbiology and Research
2019
2674-418X
http://dx.doi.org/10.31487/j.CMR.2019.01.04
https://www.sciencerepository.org/patient-related-factors-affecting-the-sensitivity-of-sonication_CMR-2019-1-104 
Abstract: Despite its decreasing incidence, prosthesis-related infections remain a research, diagnostic, therapeutic and
cost-related problem. Our study aim was to compare the diagnostic accuracy of conventional periprosthetic
tissue culture and culture of sonication fluid of the explanted hardware and to investigate the role of patientrelated factors affecting the sensitivity of the sonication method. We investigated 70 patients undergoing
revision hip or knee arthroplasty, at our institution. Patients’ medical history and demographic
characteristics were recorded. We compared the culture of samples obtained by sonication of explanted hip
and knee prostheses with conventional culture of periprosthetic tissue for the microbiological diagnosis of
prosthetic-joint infection. Thirty-two patients had septic loosening and 38 aseptic loosening (48 hip
prostheses and 22 knee prostheses). The sensitivities of sonication fluid culture and conventional tissue
cultures were 81.25% and 56.25%, respectively (p-value = 0.043). The sensitivity of the sonication method
was statistically higher in obese, diabetic patients, with age above 60, in uncemented arthroplasties and in
arthroplasties because of primary osteoarthritis (p-values < 0.05). The sonication method has a greater
sensitivity than the conventional periprosthetic tissue cultures for the periprosthetic infections, especially in
obese, diabetic patients, with age above 60, in uncemented arthroplasties and in arthroplasties because of
primary osteoarthritis. Keywords: Sonication, biofilm, orthopedic implants, total hip and knee arthroplasty infections