Format

Send to

Choose Destination
See comment in PubMed Commons below
Clin Orthop Relat Res. 2014 Jul;472(7):2208-14.

Sonication of antibiotic spacers predicts failure during two-stage revision for prosthetic knee and hip infections.

Erratum in

  • Clin Orthop Relat Res. 2014 Jul;472(7):2307.

Abstract

BACKGROUND:

Periprosthetic joint infection is a leading cause of failure after two-stage reimplantation. One cause of relapse may be persistent subclinical infection. Difficulty exists in detecting biofilm-forming infections. Sonication disrupts biofilm and has led to higher rates of positive intraoperative cultures.

QUESTIONS/PURPOSES:

Our aims in this study were to determine (1) if sonication results were predictive of failure, including reinfection, at 2-year followup; and (2) whether sonication of antibiotic spacers at the time of reimplantation improves sensitivity of intraoperative cultures.

METHODS:

We prospectively followed 36 consecutive patients undergoing two-stage reimplantation for periprosthetic hip or knee infection. Minimum followup was 19 months (mean, 29.9 months; range, 19–38 months). Results of intraoperative cultures and sonicated antibiotic spacers were analyzed.

RESULTS:

Positive sonication results were predictive of failure as defined by reinfection at 2-year followup. Among the 18 patients who had positive sonication results, reinfection developed in nine patients (50%) compared with two of 18 patients (11%) with negative sonication results (odds ratio, 8.0; 95% CI, 1.2–69.0). Sonication of antibiotic spacers improved the sensitivity of intraoperative cultures from 45% to 82%. [corrected].

CONCLUSIONS:

Sonication of antibiotic spacers appears to be useful in predicting failure attributable to recurrent infection after two-stage reimplantation. For patients with positive sonication cultures during reimplantation, more aggressive antimicrobial treatment may be indicated after reimplantation.

LEVEL OF EVIDENCE:

Level III, diagnostic study. See the Instructions for Authors for a complete description of levels of evidence.

PMID:
24658903
PMCID:
PMC4048437
DOI:
10.1007/s11999-014-3571-4
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer Icon for PubMed Central
    Loading ...
    Support Center