Identification of Asymptomatic Prosthetic Joint Infection: Microbiologic and Operative Treatment Outcomes

Bereza, Przemysław; Ekiel, Alicja; Auguściak‐Duma, Aleksandra; Aptekorz, Małgorzata; Wilk, Iwona; Wojciechowski, Piotr; Kusz, Damian; Martirosian, Gayane

doi:10.1089/sur.2016.253

Cited by 14 publications

(33 citation statements)

References 22 publications

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“…After the initial screening of titles and abstracts, the full texts of 34 articles were downloaded and assessed for eligibility. Ultimately, nine (19)(20)(21)(22)(23)(26)(27)(28)(29) articles satisfied all the inclusion criteria for the systemic review. Bereza et al published two (22,29) studies in which overlapping patients were subject to separate microbiologic tests (sonication fluid culture and sonication fluid PCR, respectively).…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…Ultimately, nine (19)(20)(21)(22)(23)(26)(27)(28)(29) articles satisfied all the inclusion criteria for the systemic review. Bereza et al published two (22,29) studies in which overlapping patients were subject to separate microbiologic tests (sonication fluid culture and sonication fluid PCR, respectively). Because this study mainly aimed at the yield of sonication fluid culture of explanted orthopedic devices, the former ( 22) was analyzed quantitatively and the latter (29) qualitatively.…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…Subsequently, several studies were undertaken using sonication fluid culture to investigate various orthopedic devices (e.g., artificial joints, pedicle screws, and osteo-synthetic instruments) that had been explanted for reasons other than infection. However, the positive yield rates reported in these studies were rather heterogeneous (20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 81%

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The yield of sonication fluid culture for presumed aseptic loosening of orthopedic devices: a meta-analysis

Xi¹,

Dong²,

Yuan³

et al. 2021

Ann Palliat Med

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Background: Sonication fluid culture is routinely conducted in patients with suspected orthopedic devicerelated infection (ORI). However, its value in the assessment of orthopedic devices that have explanted because of presumed aseptic loosening is still debatable. A meta-analysis was conducted to estimate the yield of sonication fluid culture in detecting the presence of microorganisms in orthopedic devices with presumed aseptic loosening, and to summarize the clinical characteristics and outcomes of these patients.Methods: A meta-analysis was performed of peer-reviewed publications detailing the characteristics of patients whose orthopedic devices were explanted for presumed aseptic loosening and who underwent subsequent sonication fluid culture. Diagnostic data were extracted and pooled to estimate the yield of sonication fluid culture for detecting the presence of microorganisms with 95% confidence intervals (CI).Results: Eight studies involving 421 patients were included in the meta-analysis analysis. The pooled results showed that sonication fluid culture had a yield of approximately 30% (95% CI: 20-41%) for identifying the presence of microorganisms in presumed aseptic loosening of orthopedic devices; this yield was higher than that of intraoperative tissue culture (22%, 95% CI: 8-41%) and aspirated fluid culture (13%, 95% CI: 7-21%). Sonication and vortexing for ≤5 min had a detection rate of 49% (95% CI: 43-55%), which exceeded that of >5 min. Coagulase-negative Streptococcus accounted for 74% (95% CI: 51-92%) of the isolated microorganisms. However, patients with positive microbiological results of sonication fluid culture and those with negative results showed similar outcomes after revision surgery.Conclusions: Colonization of low-virulent microorganisms may exist in a considerable number of patients with clinically presumed aseptic loosening of orthopedic devices. When this occurs, sonication (1-5 min at 40 kHz) of fluid culture could act as a sensitive diagnostic tool. However, the question of whether sonication fluid culture should be integrated into the routine treatment of loosened orthopedic devices requires further investigation.

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Section: Literature Search Resultsmentioning

confidence: 99%

Section: Literature Search Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 81%

See 1 more Smart Citation

The yield of sonication fluid culture for presumed aseptic loosening of orthopedic devices: a meta-analysis

Xi¹,

Dong²,

Yuan³

et al. 2021

Ann Palliat Med

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“…The causes of artificial joint replacement failure mainly included aseptic loosening, abrasion, dislocation and fracture of prostheses, prosthetic fracture and infection, however, aseptic loosening was the major factor (Deng et al, ). The main reasons for the aseptic loosening of artificial joints comprised mechanical factors, such as fretting wear between prostheses and bones, hydraulic pressure, stress‐shielding, abrasion and so on, and biological factors including biocompatibility of artificial joints, endotoxin and PIO (Bereza et al, ). However, PIO remained a major cause of early implant loosening.…”

Section: Discussionmentioning

confidence: 99%

MiR‐377 inhibits wear particle‐induced osteolysis via targeting RANKL

Xiaomeng

et al. 2019

Cell Biology International

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Periprosthetic osteolysis caused by wear particles is the main factor that affects the long‐term efficacy of artificial joint replacement, and macrophages play a vital role in the pathogenesis of periprosthetic osteolysis, while the potential mechanism underlying this is still unclear. To investigate the underlying role of miR‐377 in wear particle‐induced osteolysis (PIO), blood samples from patients undergoing arthroplasty were collected for analyzing the correlation between miR‐377 expression and the clinicopathological parameters of PIO. Peripheral blood macrophages were obtained to compare the miR‐377 and receptor activator of NF‐κB ligand (RANKL) expressions. Bone marrow macrophages (BMMs) following titanium (Ti) particle treatment and/or miR‐377 mimic transfection were used. The expressions of RANKL, pro‐inflammatory cytokines interleukin 6 (IL‐6) and tumor necrosis factor‐α (TNF‐α) and the osteoclast‐related molecules tartrate‐resistant acid phosphatase (TRAP) and cathepsin K (CTSK) were determined using real‐time polymerase chain reaction or western blotting or enzyme‐linked immunosorbent assay or TRAP staining, when appropriate. The interaction between miR‐377 and RANKL was assessed by luciferase reporter assay. The in vivo role of miR‐377 in PIO was evaluated using a mouse calvarial osteolysis model. There were significant differences in downregulated miR‐377 expression between the different numbers of particles in the joint prostheses. The Ti particle treatment increased pro‐inflammatory cytokine levels, downregulated RANKL and increased osteoclast activity in BMMs, while miR‐377 overexpression led to the opposite effect. Taken together, miR‐377 downregulated the target gene RANKL, resulting in PIO inhibition. MiR‐377 relieved PIO by negatively regulating RANKL.

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“…Sonication with and without multiplex polymerase chain reaction (PCR) increased the sensitivity of organism identification in chronic PJI cases [33][34][35][36][37][38][39][40] but was not more effective than tissue culture in identifying occult infection in aseptic revision total joint arthroplasty cases 41 . When sampling tissue, 3 to 4 tissue samples should be obtained when treating PJI to facilitate organism identification and antimicrobial management, in the experience of 2 institutions 42,43 .…”

Section: Diagnosismentioning

confidence: 99%