Contribution of Sonication to the Identification of Megaprosthesis Infection in Culture Negative Oncologic Patient

Area of Science:

• Orthopedic Oncology
• Infectious Diseases
• Biotechnology

Background:

• Osteosarcoma commonly affects long bones in young individuals, with increasing use of megaprostheses in treatment.
• Prosthetic joint infections are a significant complication following oncological surgery, with biofilm-forming bacteria posing a challenge.
• Biofilms protect bacteria, making them resistant to conventional antimicrobial therapies and diagnostic methods.

Observation:

• A 12-year-old patient with a femoral osteosarcoma developed a post-surgical prosthetic infection.
• Standard soft tissue cultures from the patient yielded negative results for bacterial growth.
• Sonication, utilizing long wave ultrasound, was applied to the retrieved implant material.

Findings:

• Sonication successfully disrupted the bacterial biofilm on the prosthetic material.
• This disruption led to a significantly higher recovery of bacterial growth compared to conventional tissue culture.
• The sonication method enabled the detection of the prosthetic joint infection despite negative soft tissue cultures.

Implications:

• Sonication represents a promising adjunctive technique for diagnosing challenging prosthetic joint infections, especially in oncological cases.
• Improved bacterial detection through sonication can lead to more timely and effective treatment strategies for patients with osteosarcoma and prosthetic infections.
• This approach may enhance patient outcomes by enabling earlier identification and management of implant-associated infections, reducing morbidity.