Are Sonication Cultures of Antibiotic Cement Spacers Useful During Second-stage Reimplantation Surgery for Prosthetic Joint Infection?

Clinical Orthopaedics and Related Research
Adam S OlsenBrian A Klatt

Abstract

Organisms may persist on polymethylmethacrylate (PMMA) spacer surfaces, and subclinical infection is postulated to be a source of infection recurrence. Several small patient series have shown a high proportion of positive sonication cultures on PMMA spacers at the second stage of a two-stage revision. However, the association between a positive sonication culture and the risk for recurrence of infection after two-stage exchange is not fully elucidated. Are cultures derived from sonication of antibiotic spacers associated with infection control or recurrence after two-stage revision for prosthetic joint infection (PJI)? Between September 2013 and April 2016, we treated 67 patients with PJI with two-stage revisions. At the second stage, all cement spacers were explanted and sonicated. A total of`10 (15%) patients were lost to followup or failed to reach 1-year followup during the study period, and another 16 (24%) were excluded for prespecified reasons, leaving 41 patients for analysis in this study. Of the 41 patients included in this study, there were 25 TKAs, 15 THAs, and one distal femoral replacement. All patients met the Musculoskeletal Infection Society criteria for PJI at Stage 1 of the two-stage revision. The most common...Continue Reading

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Citations

Oct 4, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Marjan Wouthuyzen-BakkerAlex Soriano
Oct 30, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Florian AmerstorferMathias Glehr

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