ArticleMicrobiologyOpen2019
High percentage of microbial colonization of osteosynthesis material in clinically unremarkable patients.
Article in MicrobiologyOpen, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Latent infections in conversion total hip arthroplasty following internal fixation of femoral neck fractures: a systematic review and meta-analysis of diagnostic methods.Archives of orthopaedic and trauma surgery · 2024Pooled it
- The boundary between microbial detection and implant-related infection: a structured narrative review of analytical credibility, biological persistence, host response, and clinical causality.Archives of orthopaedic and trauma surgery · 2026Review
- The diagnostic potential of combined quantitative polymerase chain reaction and next-generation sequencing using the same primers for periprosthetic joint infection.Microbiology spectrum · 2026Article
- Peri-implant soft tissue colonization after osteosynthesis in asymptomatic patients: a prospective study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Radiomics-driven prediction of postoperative infection risk in maxillofacial fractures: multidimensional risk factor analysis and model construction based on absorbable plate fixation.Clinical oral investigations · 2026Review
- Time-dependent microbial colonisation of temporary external fixations: a prospective descriptive study.Journal of orthopaedic surgery and research · 2026Article
- [One- or two-stage approach after osteosynthesis failure in proximal femur fracture-a narrative review].Orthopadie (Heidelberg, Germany) · 2026Review
- 5- months exposed implant after osteosynthesis is not necessarily a problem: A case report of a distal tibia fracture.Trauma case reports · 2025Article
- Microbiological Sampling in Total Knee Arthroplasty After Post-Traumatic Osteoarthritis: Rate of Periprosthetic Joint Infection and the Debate Around Sampling Unremarkable Tissue.Microorganisms · 2025Article
- Investigating the Translational Value of Periprosthetic Joint Infection Models to Determine the Risk and Severity of Staphylococcal Biofilms.ACS infectious diseases · 2024Article
- Worrying Presence of Asymptomatic Bacterial Colonisation on Implanted Orthopedic Devices.Cureus · 2024Article
- Investigating the translational value of Periprosthetic Joint Infection (PJI) models to determine the risk and severity of Staphylococcal biofilms.bioRxiv : the preprint server for biology · 2024Article
- Antibiotic-Polyphosphate Nanocomplexes: A Promising System for Effective Biofilm Eradication.International journal of nanomedicine · 2024Article
- Treatment of Fracture-Related Infection after Pelvic Fracture.Journal of clinical medicine · 2023Article
- Comparison of Mid-Infrared Handheld and Benchtop Spectrometers to DetectBioengineering (Basel, Switzerland) · 2023Article
- Osteosynthesis-associated infection in maxillofacial surgery by bacterial biofilms: a retrospective cohort study of 11 years.Clinical oral investigations · 2023Article
- Fluorescence In Situ Hybridization as Diagnostic Tool for Implant-associated Infections: A Pilot Study on Added Value.Plastic and reconstructive surgery. Global open · 2023Article
- Single-stage total hip arthroplasty after failed fixation of proximal femoral fractures: an increased risk for periprosthetic joint infections?Archives of orthopaedic and trauma surgery · 2022Article
- Current treatments for biofilm-associated periprosthetic joint infection and new potential strategies.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2022Review
- Is implant sonication useful when screening for infection in conversion of prior hip fracture fixation to total hip arthroplasty?The Journal of international medical research · 2021Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Stabilization of fractures with internal fixation devices is a common procedure and implant-associated infections are a dreaded complication. The exact pathomechanism is not completely understood; however, microbial colonization of osteosynthesis material is considered a trigger for infection. This study aimed to determine the colonization rate of osteosynthesis implants in patients with no clinical or laboratory signs of infection, using two methods, conventional culture and polymerase chain reaction (PCR) of sonication fluid. Fifty-seven patients aged between 18 and 79 years without signs of infection who underwent routine removal of osteosynthesis devices between March 2015 and May 2017 were included in this study. Osteosynthesis material was investigated by sonication followed by cultivation of the sonication fluid in blood culture bottles and PCR analysis, simultaneously. Additionally, electron scanning microscopy was performed in nine representative implants to evaluate biofilm production. Thirty-two (56.1%) implants showed a positive result either by culture or PCR with coagulase-negative staphylococci being the most commonly identified microorganism (68.1%). Furthermore, the detection rate of the culture (50.9%) was significantly higher compared to PCR (21.1%). The scanning electron microscopy imaging demonstrated biofilm-like structures in four of six culture and/or PCR-positive samples. This study is the first, to the best of our knowledge, to demonstrate bacterial colonization of osteosynthesis implants in healthy patients with no clinical or laboratory signs of infection. Colonization rate was unexpectedly high and conventional culture was superior to PCR in microbial detection. The common understanding that colonization is a trigger for infection underlines the need for strategies to prevent colonization of implant material like antibiotic-loaded coating or intraoperative gel application.
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Registered trials
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