Evaluation of the use of sonication of retrieved implants for the diagnosis of prosthetic joint infection in a routine setting |
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Authors: | Laura Prieto-Borja Álvaro Auñón Antonio Blanco Ricardo Fernández-Roblas Ignacio Gadea Joaquín García-Cañete Raúl Parrón Jaime Esteban |
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Institution: | 1.Department of Clinical Microbiology,IIS-Fundación Jiménez Díaz,Madrid,Spain;2.Department of Orthopaedic Surgery,IIS-Fundación Jiménez Díaz,Madrid,Spain;3.Department of Internal Medicine-Emergencies,IIS-Fundación Jiménez Díaz,Madrid,Spain |
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Abstract: | In order to evaluate the usefulness of sonication of retrieved implants for the diagnosis of prosthetic joint infection (PJI) in a large group of patients in a routine setting, we designed a 3-year retrospective study. Patients were classified into two groups: those meeting the clinical criteria of PJI and those that did not (control group). Two hundred patients and 276 samples were included. The types of infection were early (n?=?44), delayed (n?=?53), positive intraoperative cultures (n?=?13) and late-acute (n?=?8). The culture sensitivities of sonicate fluid, periprosthetic tissue, synovial fluid and combination of periprosthetic tissue and/or synovial fluid were 69.5, 52.8, 54.8 and 60.2%, respectively. The specificities were 97.6, 90.3, 93.0 and 89.9%, respectively. Sonicate fluid culture of implants was more sensitive than peri-implant tissue, synovial fluid and combination of periprosthetic tissue and/or synovial fluid for all infection types, though it was especially useful in delayed infection: 91.3% vs. 60.0% (p?=?0.0015), 63.2% (p?=?0.0005) and 66.7% (p?=?0.0001), respectively. When sonicate fluid culture of implants was performed in addition to conventional cultures, the sensitivity increased significantly in total (from 60.2 to 77.1%) and delayed PJI (from 45.1 to 71.7%). On the other hand, for early PJI, sonicate fluid culture of prosthesis was not superior to conventional diagnostic methods. |
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