Implant surface culturing method may identify biofilm, patterns of growth on prostheses
Click Here to Manage Email Alerts
Key takeaways:
- Implant surface culturing method had a specificity of 57.1% vs. intraoperative tissue cultures.
- Implant surface culturing method had a specificity of 80% vs. Musculoskeletal Infection Society criteria.
LAS VEGAS — Results presented here showed an implant surface culturing method may identify biofilm on culture-negative periprosthetic joint infections, as well as patterns of growth on total knee prostheses.
“While the implant surface culture is unlikely to be adopted as routine culturing method, it could provide some more assistance in these tricky cases to find out where bacteria are hiding and, therefore, lead to more efficient wash-out procedures, more targeted debridements and more efficient implant design in the long run,” Jacob R. Brooks, BS, a medical student at The Ohio State University College of Medicine, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Brooks and colleagues used an implant surface culturing method to culture biofilm and localize bacterial growth on explanted components from 14 consecutive surgical cases involving revision total joint arthroplasty due to suspected periprosthetic joint infection.
“Once the explanted components were taken from the operating rooms to the laboratory, we coated them entirely with agar, allowed them to harden and then monitored them for 9 days,” Brooks said.
Researchers recorded presence of growth, picked and plated colonies on selective agar to determine the presence of Staphylococcus aureus and analyzed specific locations of outgrowth for patterns of biofilm accumulation. Researchers also compared implant surface culturing method outcomes with clinical culturing results and PJI diagnosis based on Musculoskeletal Infection Society (MSIS) criteria.
Brooks noted outgrowth from the agar overlay was present in 10 cases. He added these cases were also implant surface culture positive. The implant surface culturing method had a sensitivity of 100% and a specificity of 57.1% when compared with intraoperative tissue cultures, according to Brooks. When compared with MSIS criteria, the specificity of the method increased to 80% and the sensitivity remained at 100%.
“Growth was mainly patchy and heterogeneous,” Brooks said. “Still, it could be localized to some specific areas, an example being the ridges of the femoral components. But the most glaring example was the surface of the tibial tray and where it comes into contact and often a locking mechanism with [polyethylene]. This area is thought to be, for bio-bacteria, [a] more tight area to fit into and might provide some protection from antimicrobial drugs and host cells.”
Collapse
Brooks JR, et al. Paper 417. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 7-11, 2023; Las Vegas.
Read more about
Click Here to Manage Email Alerts