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Updated: Mar 14, 2026
A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
Published on: March 3, 2023
Increased rate of bacterial colonization on PE-components in total joint arthroplasty: An evaluation through
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:
Twenty 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.
Insights
Periprosthetic joint infection (PJI) bacteria can remain on retained components after surgery. Polyethylene components show higher bacterial isolation rates, suggesting isolated component exchange needs antimicrobial therapy.
Area of Science:
- Orthopedic Surgery
- Infectious Disease
- Biomaterials Science
Background:
- Periprosthetic joint infection (PJI) management remains challenging.
- Uncertainty exists regarding bacterial eradication after isolated mobile component exchange in PJI.
- Investigating bacterial distribution on retained prosthetic components is crucial.
Purpose of the Study:
- To determine if bacteria colonize specific joint components or are widespread.
- To assess bacterial adherence to different implant materials in PJI cases.
- To guide surgical strategies for managing PJI.
Main Methods:
- Retrospective cohort study of 284 revision hip/knee arthroplasty patients.
- Collected synovial fluid, periprosthetic tissue, histological samples, and sonicate fluid cultures (SFC).
- Analyzed bacterial species and their origin from individual endoprosthetic components.
Main Results:
- 72% of multiple SFCs showed concordant results (all negative or all positive).
- Polyethylene (PE) components demonstrated significantly higher bacterial isolation rates compared to non-mobile components.
- While all components showed some colonization, differences between non-PE components were not statistically significant.
Conclusions:
- Polyethylene components are more prone to bacterial isolation in PJI.
- Isolated bearing exchange for PJI requires complementary antimicrobial therapy.
- Findings emphasize the need for comprehensive debridement and targeted antimicrobial treatment.
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