Abstract: BACKGROUND: It is currently unclear if an isolated exchange of the
mobile components, in cases of periprosthetic joint infection (PJI), leads
to a complete eradication of all bacteria or if residual bacteria remain
attached to the retained components? OBJECTIVE: The purpose of this study was to investigate if bacteria
only adhere to certain components or materials, or if they are ubiquitously
distributed throughout the joint. METHODS: Two hundred and eighty-four patients undergoing revision
total hip or total knee arthroplasty surgery were included in this retrospective cohort study.
Synovial fluid cultures, periprosthetic tissue cultures, histological
samples and sonicate fluid cultures (SFC) from the individual endoprosthetic
components were acquired. The isolated bacterial species were recorded
according to their endoprosthetic component of origin. RESULTS: In 72% of all cases with multiple SFC, the cultures
were concordant with all samples being either homogenously negative or
showing positive bacterial growth. The polyethylene (PE) components
showed a significantly higher rate of bacterial isolation than the
non-mobile components. All components and materials showed bacterial
colonization, however between all other components or materials were not
statistically significant. CONCLUSIONS: PE-components show a higher rate of bacterial
isolation than other components. If an isolated bearing exchange is
performed this should be supplemented by adequate antimicrobial therapy.
Keywords: Sonication, bacterial colonization, endoprosthetic components, PJI, total joint arthroplasty
