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The Scientific World Journal
Volume 2013 (2013), Article ID 375140, 5 pages
Clinical Study

Sonication: A Valuable Technique for Diagnosis and Treatment of Periprosthetic Joint Infections

13rd Department of Orthopaedic Surgery, University of Athens, KAT Hospital, Nikis 2 Street, 14561 Athens, Greece
2Department of Microbiology, KAT Hospital, Nikis 2 Street, 14561 Athens, Greece
3Department of Orthopaedic Surgery, Inselspital, University of Bern, 3010 Bern, Switzerland

Received 14 July 2013; Accepted 18 August 2013

Academic Editors: S.-Y. Kim, M. S. Lee, and C. S. Mow

Copyright © 2013 D. S. Evangelopoulos et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Periprosthetic joint infection (PJI) is the most severe complication, following joint arthroplasty. Identification of the causal microbial factor is of paramount importance for the successful treatment. Purpose. The aim of this study is to compare the sonication fluid cultures derived from joint prosthetic components with the respective periprosthetic tissue cultures. Methods. Explanted prosthesis components for suspected infection were placed into a tank containing sterile Ringer's solution and sonicated for 1 minute at 40 kHz. Sonication fluid cultures were examined for 10 days, and the number and identity of any colony morphology was recorded. In addition, periprosthetic tissue specimens (>5) were collected and cultured according to standard practice. The duration of antimicrobial interruption interval before culture sampling was recorded. Results. Thirty-four patients composed the study group. Sonication fluid cultures were positive in 24 patients (70.5%). Sixteen of thirty four periprosthetic tissue cultures (47.1%) were considered positive, all revealing the same microbial species with the respective sonication fluid cultures: 3 tissue samples showed polymicrobial infection. All tissue cultures were also found positive by the sonication fluid culture. Conclusions. Sonication fluid cultures represent a cheap, easy, accurate, and sensitive diagnostic modality demonstrating increased sensitivity compared to periprosthetic tissue cultures (70.5 versus 47.1%).