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Bacterial adherence to different components of total hip prosthesis in patients with prosthetic joint infection
Richard Lass1, Alexander Giurea, Bernd Kubista
1Department of Orthopedic Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria, richard.lass@meduniwien.ac.at.
Purpose:
The purpose of our study was to evaluate and quantify the bacterial adherence to the different components of total hip prosthesis.
Methods:
The bacterial load of 80 retrieved hip components from 24 patients was evaluated by counting of colony-forming units (CFU) dislodged from component surfaces using the sonication culture method.
Results:
Micro-organisms were detected in 68 of 80 explanted components. The highest bacterial load was detected on the polyethylene liners, showing a significant difference in distribution of CFU between the liner and metal components (stem and cup). Staphylococcus epidermidis was identified as the pathogen causing the highest CFU count, especially from the polyethylene liner.
Conclusions:
Results of our study confirm that sonicate culture of the retrieved liners and heads, which revealed the highest bacterial loads, are reliable and sufficient for pathogen detection in the clinical diagnostic routine.
Insights
This study quantified bacterial adherence on total hip prosthesis components. Polyethylene liners showed the highest bacterial load, with Staphylococcus epidermidis being the most common pathogen.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Microbiology
Background:
- Total hip prosthesis (THP) components can harbor bacteria, potentially leading to infection.
- Quantifying bacterial adherence is crucial for understanding THP-related infections.
Purpose of the Study:
- To evaluate and quantify bacterial adherence to various components of total hip prostheses.
- To identify specific prosthetic components with higher bacterial colonization.
Main Methods:
- Bacterial load assessment of 80 retrieved hip components from 24 patients.
- Utilized the sonication culture method to dislodge and count colony-forming units (CFU).
Main Results:
- Micro-organisms were detected on 68 out of 80 explanted components.
- Polyethylene liners exhibited the highest bacterial load (CFU), significantly more than metal components (stem and cup).
- Staphylococcus epidermidis was the predominant pathogen, particularly on polyethylene liners.
Conclusions:
- Sonication culture of retrieved liners and heads is reliable for pathogen detection.
- Polyethylene liners are a significant site for bacterial accumulation in THP components.
- Findings support sonicate culture for routine clinical diagnosis of THP infections.
