Dapunt Ulrike, Lehner Burkhard, Burckhardt Irene, Zimmermann Stefan, Hänsch Gertrud M, Ewerbeck Volker
1 Department for Orthopedics, Traumatology and Paraplegiology, University of Heidelberg, Heidelberg - Germany.
J Appl Biomater Funct Mater. 2014 Dec 30;12(3):135-40. doi: 10.5301/jabfm.5000205.
Infections of implants pose a severe problem in the field of orthopedic surgery, because they can cause bone degradation with subsequent loosening of the implant. The discrimination between septic implant loosening and aseptic loosening can be a challenge, and hence novel diagnostic methods have been introduced to improve the detection of bacteria. Because a major problem is their firm adherence to implants due to biofilm formation, sonication has been introduced, followed by identification of bacteria by culture or genetic methods. In this study, we compared the results obtained after sonication pretreatment with those of microbiological testing of tissue samples and histopathological evaluation of the same tissue. Furthermore, we related the results obtained following sonication to the clinical diagnosis of septic or aseptic implant loosening, respectively. Sonication of explanted devices also enhances the likelihood of detecting bacterial growth in patients who were considered "aseptic" based on the clinical evaluation.
植入物感染在整形外科领域是一个严重问题，因为它们会导致骨质降解，随后植入物松动。区分感染性植入物松动和无菌性松动可能具有挑战性，因此已引入新的诊断方法以改进细菌检测。由于一个主要问题是细菌因形成生物膜而牢固附着于植入物，所以采用了超声处理，随后通过培养或基因方法鉴定细菌。在本研究中，我们将超声预处理后获得的结果与组织样本的微生物检测结果以及同一组织的组织病理学评估结果进行了比较。此外，我们将超声处理后获得的结果分别与感染性或无菌性植入物松动的临床诊断相关联。对取出装置进行超声处理也增加了在临床评估中被认为“无菌”的患者中检测到细菌生长的可能性。
