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Updated: Aug 30, 2025
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Molecular Approach for the Laboratory Diagnosis of Periprosthetic Joint Infections
Giulia Gatti1, Francesca Taddei1, Martina Brandolini1
1Unit of Microbiology, The Great Romagna Hub Laboratory, 47522 Pievesestina, Italy.
Abstract:
The incidence of total joint arthroplasty is increasing over time since the last decade and expected to be more than 4 million by 2030. As a consequence, the detection of infections associated with surgical interventions is increasing and prosthetic joint infections are representing both a clinically and economically challenging problem. Many pathogens, from bacteria to fungi, elicit the immune system response and produce a polymeric matrix, the biofilm, that serves as their protection. In the last years, the implementation of diagnostic methodologies reduced the error rate and the turn-around time: polymerase chain reaction, targeted or broad-spectrum, and next-generation sequencing have been introduced and they represent a robust approach nowadays that frees laboratories from the unique approach based on culture-based techniques.
Insights
Total joint arthroplasty infections are a growing challenge. Advanced molecular diagnostics like polymerase chain reaction and next-generation sequencing offer faster, more accurate detection than traditional culture methods.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Biotechnology
Background:
- Total joint arthroplasty (TJA) incidence is rising, projected to exceed 4 million by 2030.
- Prosthetic joint infections (PJIs) pose significant clinical and economic burdens.
- Pathogens form protective biofilms, complicating diagnosis and treatment.
Purpose of the Study:
- To highlight the increasing challenge of prosthetic joint infections.
- To discuss advancements in diagnostic methodologies for PJIs.
- To emphasize the shift from culture-based techniques to molecular approaches.
Main Methods:
- Review of current literature on PJI diagnostics.
- Discussion of polymerase chain reaction (PCR) techniques (targeted and broad-spectrum).
- Exploration of next-generation sequencing (NGS) applications in PJI detection.
Main Results:
- Molecular diagnostic methods significantly reduce error rates and turnaround times.
- PCR and NGS provide robust detection of diverse pathogens.
- These advanced techniques offer alternatives to conventional culture-based methods.
Conclusions:
- Modern molecular diagnostics are crucial for timely and accurate PJI detection.
- The adoption of PCR and NGS improves laboratory efficiency and diagnostic confidence.
- These advancements are vital in managing the growing clinical and economic impact of PJIs.
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