Total Hip Replacement Clinical Trial
Official title:
Biofilm Investigation on Ceramic, Metal and Polyethylene Bearing Components From Explanted Hip Joint Prosthesis
In this study the investigators sonicate the bearing components of the explanted hip prosthesis which allows highly sensitive detection of in vivo biofilms (qualitatively and quantitatively). The hip prosthesis bearing components are composed from different material. The purpose of this study is to analyse the resistance against biofilm adhesion of ceramic, metal and polyethylene prosthesis components through microbiologic analysis of sonicates.
The main reasons for hip prosthesis failure are aseptic loosening and periprosthetic joint
infection (PJI). The real frequency of PJI is probably largely underestimated because of
non-standardized definition criteria, diagnostic procedure, treatment algorithm and other
confounders. Therefore, data from joint registries are not reflecting the frequency of PJI
and can be misleading; particularly low-grade PJI can be frequently misdiagnosed as aseptic
failure.
Microbiological analysis of sonicate has in comparison with joint aspirate significantly
higher sensitivity and specificity, which allows better detection of low grade infection.
With aspiration only free-floating, high metabolically active, planktonic form of bacteria
could be collected. Contrarily, the less metabolically active bacteria are hidden under the
biofilm can remain undetected.
Sonication of prosthetic material mechanically dislodge the biofilm from surface and expose
the sessile bacteria for the microbiological analysis.
All foreign materials provoke biofilm formation however, different materials showed
different resistance for biofilm adhesion.
In this study patients with PJI are undergoing standard one- or two- stage revision
procedure of the hip. The removed bearing components will be sonicated and sent in
microbiological analysis. The ceramic, metal and polyethylene prosthesis components will
undergo qualitative and quantitative microbiological analysis. The materials will be
compared regarding to the presence of biofilm formation.
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Observational Model: Cohort, Time Perspective: Prospective
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