Evidence map›Paper›PMID 40775645›Full record

ArticleJournal of orthopaedic surgery and research2025

Microbiologic analysis of 140 patients undergoing revision total knee arthroplasty due to periprosthetic joint infection and aseptic loosening: droplet digital PCR analysis.

Xiao-Kai Liu, Heng-Xin Zhao, Lan-Feng Ding, Yuan-He Wang, Shao-Qi Tian

Abstract read
In one paragraph

Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Xiao-Kai LiuDepartment of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266071, Shandong, China. 17660697361@163.com.
Heng-Xin ZhaoDepartment of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266071, Shandong, China.
Lan-Feng DingDepartment of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266071, Shandong, China.
Yuan-He WangDepartment of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266071, Shandong, China.
Shao-Qi TianDepartment of Orthopedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266071, Shandong, China. shaoqi99@aliyun.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe primary reasons for postoperative joint prosthesis revision after total knee arthroplasty (TKA) are periprosthetic aseptic prosthesis loosening and joint infection (PJI). The objective of this study is to analyze the predominant microbial species responsible for PJI while also discussing was related.

methodsA retrospective analysis was conducted on patients who underwent TKA revision surgery for the treatment of PJI and aseptic loosening of joint prostheses at our institution. Patients with aseptic loosening of the prosthesis are group A (n = 68), and patients with PJI are group B (n = 72). The fluid obtained after ultrasonic treatment was then subjected to microbial culture. Droplet Digital PCR (ddPCR) analysis was employed for DNA detection.

resultsIn our study, we included a total of 140 patients divided into groups A (patients with aseptic loosening of the prosthesis) and B (patients with PJI). The microbial culture results showed that 30 patients (45.45%) had Staphylococcus aureus infections, and 24 patients (36.36%) had methicillin-resistant Staphylococcus aureus (MRSA) infections in group B. The DNA testing results revealed that 54.41% (n = 37) of Group A patients still had microbial infections, including both Gram-positive and Gram-negative species. Notably, these patients showed negative microbial cultures but positive DNA detection. Among them, 83.78% (n = 31) had Gram-negative infections, while 16.22% (n = 6) had Gram-positive infections. In Group B, 66 patients (91.67%) had predominantly Gram-positive infections.

conclusionThis study innovatively employed ddPCR for DNA detection and microbiologic analysis in 140 patients undergoing revision total knee arthroplasty due to periprosthetic joint infection and aseptic loosening, showed that most patients with PJI mainly affected by infections caused by high-virulence Gram-positive microbe, especially Staphylococcus aureus and MRSA. On the other hand, patients with aseptic loosening of the prosthesis may be associated with a history of multiple low-virulence microbial infections, primarily involving Gram-negative bacteria.

Indexed as

Arthroplasty, Replacement, KneeKnee ProsthesisPolymerase Chain ReactionProsthesis FailureProsthesis-Related InfectionsReoperationAgedAged, 80 and overFemaleHumansMaleMethicillin-Resistant Staphylococcus aureusMiddle AgedRetrospective StudiesStaphylococcal InfectionsAseptic loosening of prosthesesDroplet digital PCR analysisMicrobial culturePeriprosthetic joint infectionTotal knee arthroplasty

Identifiers

PMID40775645
PMCPMC12329902

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.