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Updated: Jun 7, 2025

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Advancing Diagnostic Techniques for Implant-Related Infections: the Synergistic Effect of Sonication and
Matthaios Bakalakos1, Margarita-Michaela Ampadiotaki2, Christos Vlachos1
13rd Orthopaedic Department, National and Kapodistrian University of Athens, KAT General Hospital, Athens, Greece.
Purpose:
Implant-related infections represent a significant complication contributing to increased morbidity and mortality. Determining the microbial agent causing the infection is crucial for successful treatment. Despite the incidence of periprosthetic joint infections (PJIs) rising over time, no diagnostic test with 100% sensitivity is available to identify these infections accurately. The present study aims to determine whether combining sonication with Dithiothreitol (DTT) enhances the accuracy and sensitivity in diagnosing implant-related infections.
Methods:
Specifically, the present study included 30 patients, who underwent implant removal due to suspicion of infection. Implants were divided into two segments: one was processed using the sonication method and the other one by combining DTT and sonication.
Results:
The mean +/-SD was 81.17 +/- 67.53 CFU/mL for the sonication group and 109.7 +/-62.78 CFU/mL for the combination group.
Conclusion:
The results of our study indicate that the combination of DTT and sonication increases the colony count by about 28.53 CFU/mL, which enhances the possibility of detecting orthopaedic implant associated infections.

