Roehrl, Alexander and Klawonn, Frank and Fuechtmeier, Bernd and Wulbrand, Christian and Gessner, Andre and Zustin, Jozef and Ambrosch, Andreas (2024) Results of a monocentric field study: value of histology compared to sonication method and conventional tissue culture in the diagnosis of periprosthetic joint infection (PJI). INFECTION, 52 (6). pp. 2287-2296. ISSN 0300-8126, 1439-0973
Full text not available from this repository. (Request a copy)Abstract
Background To confirm the diagnosis of periprosthetic joint infection (PJI), the Infectious Diseases Society of America (IDSA) and the International Consensus Meeting (ICM) have defined criteria that include histology as a minor criterion and the sonication method only as an additional criterion. The aim of this monocentric, retrospective study was to investigate the value of histology and whether sonication leads to a more accurate diagnosis. Materials and methods All revision surgeries for knee and hip arthroplasty between 2017 and 2020 were included. With regard to microbiological diagnostic, conventional culture of periprosthetic biopsies and sonication of explant material were performed. In addition, histology and non-specific inflammatory markers (CRP, leukocytes) were recorded. Results A total of 78 patients with PJI and 62 aseptic controls were included. From both microbiological methods (conventional culture / sonication), Staphyloccus (S.) epidermidis and S. aureus were detected most frequently. However, compared to the conventional microbiology, a higher sensitivity was calculated for sonication, albeit with a lower specificity in relation to a PJI. In two logistic regression models for the significance of all diagnostic parameters in PJI, the AUC was 0.92 and 0.96 with histology in particular making the decisive contribution in both models (p < 0. 001, both models). Conclusion Since histology showed the highest accuracy in the current study, its importance in the PJI criteria should be reevaluated. Sonication shows a high sensitivity for germ detection with a lower specificity and should only be used in combination with the conventional culture for microbiolgical diagnostics.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TOTAL HIP-ARTHROPLASTY; KNEE ARTHROPLASTY; IMPLANT SONICATION; DEEP INFECTION; REVISION HIP; RISK; EPIDEMIOLOGY; PJI; Histology; Sonication; Minor citeria |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Sep 2025 05:23 |
| Last Modified: | 09 Sep 2025 05:23 |
| URI: | https://pred.uni-regensburg.de/id/eprint/64267 |
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