Articles | Volume 11, issue 4
https://doi.org/10.5194/jbji-11-555-2026
https://doi.org/10.5194/jbji-11-555-2026
Original full-length article
 | 
26 Aug 2026
Original full-length article |  | 26 Aug 2026

Sonication versus peri-implant tissue culture in fracture-related infection: diagnostic performance and therapeutic consequences in a single-center cohort

Belal Abdo, Daniel Strack, Marcel Schäuffele, Tim Ludwig Tüngler, Can Imirzalioglu, Anita Windhorst, Moritz Fritzenwanker, Christian Heiss, and Markus Rupp

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Cited articles

Anagnostopoulos, A., Bossard, D. A., Ledergerber, B., Zingg, P. O., Zinkernagel, A. S., Gerber, C., and Achermann, Y.: Perioperative Antibiotic Prophylaxis Has No Effect on Time to Positivity and Proportion of Positive Samples: a Cohort Study of 64 Cutibacterium acnes Bone and Joint Infections, J. Clin. Microbiol., 56, e01576-17, https://doi.org/10.1128/JCM.01576-17, 2018. 
Bellova, P., Knop-Hammad, V., Königshausen, M., Mempel, E., Frieler, S., Gessmann, J., Schildhauer, T. A., and Baecker, H.: Sonication of retrieved implants improves sensitivity in the diagnosis of periprosthetic joint infection, BMC Musculoskel. Dis., 20, 623, https://doi.org/10.1186/s12891-019-3006-1, 2019. 
Bellova, P., Knop-Hammad, V., Königshausen, M., Schildhauer, T. A., Gessmann, J., and Baecker, H.: Sonication in the diagnosis of fracture-related infections (FRI) – a retrospective study on 230 retrieved implants, J. Orthop. Surg. Res., 16, 310, https://doi.org/10.1186/s13018-021-02460-z, 2021. 
Corrigan, R. A., Sliepen, J., Dudareva, M., IJpma, F. F. A., Govaert, G., Atkins, B. L., Rentenaar, R., Wouthuyzen-Bakker, M., and McNally, M.: Causative Pathogens Do Not Differ between Early, Delayed or Late Fracture-Related Infections, Antibiotics, 11, 943, https://doi.org/10.3390/antibiotics11070943, 2022. 
Depypere, M., Sliepen, J., Onsea, J., Debaveye, Y., Govaert, G. A. M., IJpma, F. F. A., Zimmerli, W., and Metsemakers, W.-J.: The Microbiological Etiology of Fracture-Related Infection, Front. Cell. Infect. Mi., 12, 934485, https://doi.org/10.3389/fcimb.2022.934485, 2022. 
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Short summary
Fracture-related infections after bone surgery are difficult to diagnose because bacteria can attach to metal implants and become hard to detect, especially when antibiotics have already been given. We compared two laboratory methods used to identify bacteria on removed implants in 157 patients. Each method alone missed some infections, but using both together improved detection and helped guide antibiotic treatment. Our findings support combining diagnostic approaches to improve patient care.
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