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Updated: May 6, 2026
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Sonication: a valuable technique for diagnosis and treatment of periprosthetic joint infections
D S Evangelopoulos1, I P Stathopoulos, G P Morassi
13rd Department of Orthopaedic Surgery, University of Athens, KAT Hospital, Nikis 2 Street, 14561 Athens, Greece.
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%).
Insights
Sonication fluid cultures are more sensitive for diagnosing periprosthetic joint infection (PJI) than tissue cultures. This method offers a cheaper, easier, and accurate diagnostic approach for PJI.
Area of Science:
- Orthopedics
- Infectious Diseases
- Microbiology
Background:
- Periprosthetic joint infection (PJI) is a severe complication after joint arthroplasty.
- Accurate identification of the causative microbe is crucial for effective PJI treatment.
Purpose of the Study:
- To compare the diagnostic accuracy of sonication fluid cultures from joint prosthetic components versus periprosthetic tissue cultures for PJI detection.
Main Methods:
- Explanted prosthetic components underwent sonication in sterile Ringer's solution (40 kHz, 1 minute).
- Sonication fluid and periprosthetic tissue specimens (>5) were cultured for 10 days.
- Antimicrobial interruption intervals were recorded prior to sampling.
Main Results:
- Sonication fluid cultures yielded positive results in 70.5% of patients (24/34).
- Periprosthetic tissue cultures were positive in 47.1% (16/34), identifying the same species as sonication fluid cultures.
- All positive tissue cultures were also detected by sonication fluid cultures, with 3 cases showing polymicrobial infections.
Conclusions:
- Sonication fluid cultures demonstrate higher sensitivity (70.5%) compared to periprosthetic tissue cultures (47.1%) for diagnosing PJI.
- This method is a cost-effective, straightforward, and accurate diagnostic tool for PJI.
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