Increased rate of bacterial colonization on PE-components in total joint arthroplasty: An evaluation through sonication

Abstract

BACKGROUND:

It is currently unclear if an isolated exchange of the mobile components, in cases of periprosthetic joint infection (PJI), leads to a complete eradication of all bacteria or if residual bacteria remain attached to the retained components?

OBJECTIVE:

The purpose of this study was to investigate if bacteria only adhere to certain components or materials, or if they are ubiquitously distributed throughout the joint.

METHODS:

Two hundred and eighty-four patients undergoing revision total hip or total knee arthroplasty surgery were included in this retrospective cohort study. Synovial fluid cultures, periprosthetic tissue cultures, histological samples and sonicate fluid cultures (SFC) from the individual endoprosthetic components were acquired. The isolated bacterial species were recorded according to their endoprosthetic component of origin.

RESULTS:

In 72% of all cases with multiple SFC, the cultures were concordant with all samples being either homogenously negative or showing positive bacterial growth. The polyethylene (PE) components showed a significantly higher rate of bacterial isolation than the non-mobile components. All components and materials showed bacterial colonization, however between all other components or materials were not statistically significant.

CONCLUSIONS:

PE-components show a higher rate of bacterial isolation than other components. If an isolated bearing exchange is performed this should be supplemented by adequate antimicrobial therapy.