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超声处理在全膝关节置换术后假体周围关节感染诊断中的作用

The Function of Sonication in the Diagnosis of Periprosthetic Joint Infection After Total Knee Arthroplasty.

作者信息

Rodriguez-Merchan E Carlos

机构信息

Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain.

出版信息

Arch Bone Jt Surg. 2022 Sep;10(9):735-740. doi: 10.22038/abjs.2020.44329.2212.

Abstract

Periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) is a serious adverse event. Culturing of samples of periprosthetic tissue is the standard technique utilized for the microbiological diagnosis of PJI. However, this technique is neither sensitive nor specific since in PJI the microorganisms are usually in a biofilm on the surface of the prosthesis. The objective of this paper is to know the role of sonication in the diagnosis of PJI after TKA. Sonication consists in taking samples of bacteria from biofilms adhered to the prosthetic surface. The reported sensitivity for the diagnosis of PJI of the periprosthetic tissue cultures and sonicate fluid cultures is 54% and 75%, apiece. The specificity is 98% and 87%, respectively. In conclusion, the sonication technique is a dependable test for the diagnosis of PJI after TKA with a greater sensitivity and specificity than the conventional periprosthetic tissue cultures. Sonication of polyethylene liners, rather than the whole prosthesis, has been reported to be sufficient for diagnosis of prosthetic joint infection.

摘要

全膝关节置换术(TKA)后假体周围关节感染(PJI)是一种严重的不良事件。假体周围组织样本培养是用于PJI微生物学诊断的标准技术。然而,该技术既不敏感也不特异,因为在PJI中微生物通常存在于假体表面的生物膜中。本文的目的是了解超声处理在TKA后PJI诊断中的作用。超声处理在于从附着于假体表面的生物膜中获取细菌样本。报道的假体周围组织培养和超声处理液培养对PJI诊断的敏感性分别为54%和75%。特异性分别为98%和87%。总之,超声处理技术是TKA后PJI诊断的可靠检测方法,其敏感性和特异性均高于传统的假体周围组织培养。据报道,对聚乙烯衬垫而非整个假体进行超声处理就足以诊断假体关节感染。

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