Study finds, Role of Sonication fluid culture of antibiotic-
Sonication fluid culture of antibiotic-loaded bone cement spacer has been used to predict reinfection of two-stage revision. This study aims to evaluate the association between the culture result of the sonicated spacer and the status of patients with periprosthetic joint infection receiving two-stage revision.

A comprehensive electronic literature search was performed to retrieve studies in which sonication fluid culture of the antibiotic spacer was conducted before reimplantation. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated to assess the association between the culture result of sonicated spacer and prognosis of the two-stage revision.

--11 eligible studies comprising 603 artificial joints with PJI (134 suffering a clinical failure of two-stage revision) were included in the quantitative analysis.

--The pooled incidences of positive culture of sonicated spacer and intraoperative tissue were 0.14 and 0.14, respectively.

--A positive culture of sonicated antibiotic-loaded bone cement spacer illustrated moderate sensitivity (0.31) but high specificity (0.94) for the diagnosis of therapeutic failure of two-stage revision; the pooled DOR was 7.67.

--Meanwhile, the pooled sensitivity, specificity, and DOR of intraoperative tissue culture during the two-stage revision to predict therapeutic failure were 0.32, 0.96, and 10.62, respectively.

Conclusively, Sonication culture of antibiotic bone cement spacers showed a high level of accuracy in the validation of infection eradication prior to the reimplantation of a new prosthesis which could therefore serve to evaluate the therapeutic efficacy of PJI.