Detection of prosthetic joint biofilm infection using immunological and molecular techniques

Publisher Summary This chapter describes how the detection of bacteria by culture from revision hip prostheses can be improved by employing strict anaerobic techniques and by using mild ultrasonication to dislodge bacteria adhering to the surface of the retrieved implants. Nonculture techniques that can be used to further improve the detection of infection, including examination of the inflammatory response in implant-associated tissue and the detection of bacteria using immunological and polymerase chain reaction (PCR)-based molecular approaches, are also described. The use of strict anaerobic techniques and mild ultrasonication has resulted in bacteria being cultured from 26 of 120 (22%) retrieved implants examined. The use of nonculture techniques to improve the detection of prosthetic joint biofilm infection coupled with appropriate postoperative antibiotic therapy should improve the clinical outcome for patients undergoing revision hip surgery.