ArticleArchives of orthopaedic and trauma surgery2023
Tissue sampling is non-inferior in comparison to sonication in orthopedic revision surgery.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Does Aspiration With Culture Augmented With Percutaneous Core Biopsy Analysis Have Better Diagnostic Value Than Culture Alone for PJI in Large Joints? A Prospective Enhancement and Feasibility Study.Clinical orthopaedics and related research · 2026Article
- Cerclage Wires Used for Extended Trochanteric Osteotomy Fixation During Two-Stage Revision Total Hip Arthroplasty for Periprosthetic Joint Infection Are Not Colonized by Bacteria: A Case Series.Arthroplasty today · 2026Article
- Concordance of three different methods to obtain samples for culture in reverse total shoulder arthroplasty: a prospective study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Prolonged incubation time unwarranted for acute periprosthetic joint infections.Journal of clinical microbiology · 2025Article
- Improving the microbiological diagnosis of fracture-related infection and prosthetic joint infection through culturing sonication fluid in Bactec blood culture bottles.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2024Article
- The value of sonication on orthopaedic implants in an everyday clinical setting - an exploratory study.BMC musculoskeletal disorders · 2023Article
- Revision surgery after failed surgical treatment of midshaft clavicle fractures is often associated with positive detection of bacteria.Archives of orthopaedic and trauma surgery · 2023Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to assess the role of sonication fluid cultures in detecting musculoskeletal infections in orthopedic revision surgery in patients suspected of having peri-prosthetic joint infection (PJI), fracture-related infections (FRI), or postoperative spinal implant infections (PSII).
methodsBetween 2016 and 2019, 149 cases with a data set including sonication fluid cultures and tissue specimen and histological analysis were included. Accuracy of each diagnostic tool as well as the influence of antibiotic therapy was analyzed. Pathogens identified in the sonication cultures and in the associated tissue samples were compared based on the matching of the antibiograms. Therapeutic benefits were then assessed.
resultsOf 149 cases, 43.6% (n = 65) were identified as PJI, 2.7% (n = 4) as FRI, 12.8% (n = 19) as PSII, 6.7% (n = 10) as aseptic non-union, and 34.2% (n = 51) as aseptic implant loosening. The sensitivity and specificity of tissue and synovial specimens showed no significant difference with respect to sonication fluid cultures (sensitivity/specificity: tissue: 68.2%/96.7%; sonication fluid cultures: 60.2%/98.4%). The administration of antibiotics over 14 days prior to microbiological sampling (n = 40) resulted in a lower sensitivity of 42.9% each. Histological analysis showed a sensitivity 86.3% and specificity of 97.4%. In 83.9% (n = 125) of the cases, the results of sonication fluid cultures and tissue specimens were identical. Different microorganisms were found in only four cases. In 17 cases, tissue samples (n = 5) or sonication (n = 12) were false-negatives.
conclusionSonication fluid culture showed no additional benefit compared to conventional microbiological diagnostics of tissue and synovial fluid cultures. Preoperative administration of antibiotics had a clearly negative effect on microbiologic test accuracy. In over 83.9% of the cases, sonication fluid and tissue cultures showed identical results. In the other cases, sonication fluid culture did not further contribute to the therapy decision, whereas other factors, such as fistulas, cell counts, or histological analysis, were decisive in determining therapy.
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