The role of sonication in the diagnosis of prosthetic joint infections

Abstract

Prosthetic joint infection represent a severe complication after joint arthtroplasty and causes severe patient morbidity, along with the financial burden for the healthcare system. The number of patients after joint arthtroplasty increases with the ageing population, therefore there is an increase in the incidence of complications. The pathogenesis of medical device infection is based on the developement of bacterial biofilm, a diagnostic and therapeutic obstacle. The implementation of a new diagnostic tool – sonication, enables disruption of bacterial biofilm and improves the sensitivity of microbiological tests, even after preoperative antimicrobial therapy. The use of sonication has shown to be crucial in doubtful cases, where the distinction between aseptic failure and prosthetic joint infection is blurred because of the absence of clinical signs of infection or negative periprosthetic tissue cultures.

Keywords

• sonication, biofilm, joint prosthesis, prosthesis-related infection, orthopedics