Sonication Leads to Clinically Relevant Changes in Treatment of Periprosthetic Hip or Knee Joint Infection
<p class="p p-first" id="__p2"><strong>Background:</strong> Diagnosis of periprosthetic joint infection (PJI) can be troublesome. Sonication can be a helpful tool in culturing bacteria that are difficult to detect with standard tissue cultures. Aim of this study...
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| Format: | Article |
| Language: | English |
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Copernicus Publications
2020-04-01
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| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/5/128/2020/jbji-5-128-2020.pdf |
| _version_ | 1818444104886910976 |
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| author | M. Hoekstra E. S. Veltman R. F.R.H.A Nurmohamed B. v. Dijk R. J. Rentenaar H. C. Vogely B. C.H. van |
| author_facet | M. Hoekstra E. S. Veltman R. F.R.H.A Nurmohamed B. v. Dijk R. J. Rentenaar H. C. Vogely B. C.H. van |
| author_sort | M. Hoekstra |
| collection | DOAJ |
| description | <p class="p p-first" id="__p2"><strong>Background:</strong> Diagnosis of periprosthetic joint infection (PJI) can be troublesome. Sonication can be a helpful tool in culturing bacteria that are difficult to detect with standard tissue cultures. Aim of this study is to evaluate the clinical importance of our standardized sonication protocol in detecting periprosthetic joint infection.</p><p id="__p3"><strong>Materials and methods:</strong> All patients with revision surgery of a hip or knee prosthesis between 2011 and 2016 were retrospectively reviewed and divided in two groups: clinically suspected of infection or not suspected of infection. For both tissue culture and implant sonication, calculations of sensitivity and specificity were performed. Clinical relevance of sonication was evaluated by calculating in which percentage of patients' sonication influenced clinical treatment.</p><p id="__p4"><strong>Results:</strong> 226 patients with revision of a total hip prosthesis (122 patients) or a total knee prosthesis (104 patients) were included. Sensitivity of perioperatively taken tissue cultures was 94.3% and specificity was 99.3%. For sonication sensitivity was 80.5% and specificity was 97.8%.</p><p id="__p5">In the infection group eight patients (9%) with only one positive tissue culture and a positive sonication fluid culture with the same pathogen were found.</p><p id="__p6"><strong>Interpretation:</strong> Although sensitivity and specificity of sonication was lower compared to tissue cultures, periprosthetic joint infection could only be established in 8 patients (9%) suspected of infection because of a positive result of the sonication fluid culture.</p><p class="p p-last" id="__p7">Sonication leads to clinically relevant changes in treatment and seems therefore to be a helpful diagnostic tool in clinical practice.</p> |
| first_indexed | 2024-12-14T19:10:38Z |
| format | Article |
| id | doaj.art-f488491c51fe47f0bd5aefe33b6e5661 |
| institution | Directory Open Access Journal |
| issn | 2206-3552 |
| language | English |
| last_indexed | 2024-12-14T19:10:38Z |
| publishDate | 2020-04-01 |
| publisher | Copernicus Publications |
| record_format | Article |
| series | Journal of Bone and Joint Infection |
| spelling | doaj.art-f488491c51fe47f0bd5aefe33b6e56612022-12-21T22:50:44ZengCopernicus PublicationsJournal of Bone and Joint Infection2206-35522020-04-01512813210.7150/jbji.45006Sonication Leads to Clinically Relevant Changes in Treatment of Periprosthetic Hip or Knee Joint InfectionM. Hoekstra0E. S. Veltman1R. F.R.H.A Nurmohamed2B. v. Dijk3R. J. Rentenaar4H. C. Vogely5B. C.H. van6Department of Orthopaedic Surgery, University Medical Centre Utrecht, the NetherlandsDepartment of Orthopaedic Surgery, University Medical Centre Utrecht, the NetherlandsDepartment of Orthopaedic Surgery, University Medical Centre Utrecht, the NetherlandsDepartment of Orthopaedic Surgery, University Medical Centre Utrecht, the NetherlandsDepartment of Clinical Microbiology, University Medical Centre Utrecht, the NetherlandsDepartment of Orthopaedic Surgery, University Medical Centre Utrecht, the NetherlandsDepartment of Orthopaedic Surgery, University Medical Centre Utrecht, the Netherlands<p class="p p-first" id="__p2"><strong>Background:</strong> Diagnosis of periprosthetic joint infection (PJI) can be troublesome. Sonication can be a helpful tool in culturing bacteria that are difficult to detect with standard tissue cultures. Aim of this study is to evaluate the clinical importance of our standardized sonication protocol in detecting periprosthetic joint infection.</p><p id="__p3"><strong>Materials and methods:</strong> All patients with revision surgery of a hip or knee prosthesis between 2011 and 2016 were retrospectively reviewed and divided in two groups: clinically suspected of infection or not suspected of infection. For both tissue culture and implant sonication, calculations of sensitivity and specificity were performed. Clinical relevance of sonication was evaluated by calculating in which percentage of patients' sonication influenced clinical treatment.</p><p id="__p4"><strong>Results:</strong> 226 patients with revision of a total hip prosthesis (122 patients) or a total knee prosthesis (104 patients) were included. Sensitivity of perioperatively taken tissue cultures was 94.3% and specificity was 99.3%. For sonication sensitivity was 80.5% and specificity was 97.8%.</p><p id="__p5">In the infection group eight patients (9%) with only one positive tissue culture and a positive sonication fluid culture with the same pathogen were found.</p><p id="__p6"><strong>Interpretation:</strong> Although sensitivity and specificity of sonication was lower compared to tissue cultures, periprosthetic joint infection could only be established in 8 patients (9%) suspected of infection because of a positive result of the sonication fluid culture.</p><p class="p p-last" id="__p7">Sonication leads to clinically relevant changes in treatment and seems therefore to be a helpful diagnostic tool in clinical practice.</p>https://jbji.copernicus.org/articles/5/128/2020/jbji-5-128-2020.pdf |
| spellingShingle | M. Hoekstra E. S. Veltman R. F.R.H.A Nurmohamed B. v. Dijk R. J. Rentenaar H. C. Vogely B. C.H. van Sonication Leads to Clinically Relevant Changes in Treatment of Periprosthetic Hip or Knee Joint Infection Journal of Bone and Joint Infection |
| title | Sonication Leads to Clinically Relevant Changes in Treatment of Periprosthetic Hip or Knee Joint Infection |
| title_full | Sonication Leads to Clinically Relevant Changes in Treatment of Periprosthetic Hip or Knee Joint Infection |
| title_fullStr | Sonication Leads to Clinically Relevant Changes in Treatment of Periprosthetic Hip or Knee Joint Infection |
| title_full_unstemmed | Sonication Leads to Clinically Relevant Changes in Treatment of Periprosthetic Hip or Knee Joint Infection |
| title_short | Sonication Leads to Clinically Relevant Changes in Treatment of Periprosthetic Hip or Knee Joint Infection |
| title_sort | sonication leads to clinically relevant changes in treatment of periprosthetic hip or knee joint infection |
| url | https://jbji.copernicus.org/articles/5/128/2020/jbji-5-128-2020.pdf |
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