Periprosthetic joint infection (PJI) is a serious complication after joint arthroplasty. PJI screening and conventional cultures may be inconclusive. Sonication fluid culturing stands out as a valuable adjunct technique for PJI diagnosis. This study aims to determine the clinical relevance of routine sonication for all (a)septic revisions. All patients who underwent (partial) hip or knee revision arthroplasty between 2012 and 2021 were retrospectively reviewed. We formed three groups based on the European Bone and Joint Society PJI criteria: infection confirmed, likely, and unlikely. We analyzed clinical, laboratory, and radiological screening. Sensitivity and specificity were calculated for synovial fluid (preoperative), tissue, and sonication fluid cultures. We determined the clinical relevance of sonication as the percentage of patients for whom sonication confirmed PJI; 429 patients who underwent (partial) revision of hip or knee arthroplasty were included. Sensitivity and specificity were 69% and 99% for synovial fluid cultures, 76% and 92% for tissue cultures, and 80% and 89% for sonication fluid cultures, respectively. Sonication fluid cultures improved tissue culture sensitivity and specificity to 83% and 99%, respectively. In 11% of PJIs, sonication fluid cultures were decisive for diagnosis. This is applicable to acute and chronic infections. Sonication fluid cultures enhanced the sensitivity and specificity of PJI diagnostics. In 11% of PJI cases, causative pathogens were confirmed by sonication fluid culture results. Sonication fluid culture should be performed in all revision arthroplasties.

中文翻译：

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评估常规超声处理对假体周围髋关节或膝关节感染诊断的临床相关性

假体周围感染（PJI）是关节置换术后的严重并发症。 PJI 筛查和常规培养可能无法得出结论。超声液体培养作为 PJI 诊断的一种有价值的辅助技术而脱颖而出。本研究旨在确定常规超声处理对于所有脓毒症修复的临床相关性。对 2012 年至 2021 年间接受（部分）髋关节或膝关节翻修术的所有患者进行回顾性分析。我们根据欧洲骨关节协会 PJI 标准组成了三个小组：确诊感染、可能感染和不太可能感染。我们分析了临床、实验室和放射学筛查。计算滑液（术前）、组织和超声处理液培养物的敏感性和特异性。我们将超声处理的临床相关性确定为超声处理证实 PJI 的患者百分比；纳入了 429 名接受（部分）髋关节或膝关节置换术的患者。滑液培养的敏感性和特异性分别为 69% 和 99%，组织培养的敏感性和特异性分别为 76% 和 92%，超声处理液体培养的敏感性和特异性分别为 80% 和 89%。超声液体培养将组织培养的敏感性和特异性分别提高到 83% 和 99%。在 11% 的 PJI 中，超声液体培养对于诊断具有决定性作用。本方适用于急性、慢性感染。超声液体培养增强了 PJI 诊断的敏感性和特异性。在 11% 的 PJI 病例中，通过超声液体培养结果证实了致病病原体。所有关节翻修术中均应进行超声液体培养。