POLYMERASE CHAIN-REACTION DETECTION OF BACTERIAL-INFECTION IN TOTAL KNEE ARTHROPLASTY

Synovial fluid aspirates from 50 patients with symptoms after total kn ee arthroplasty were analyzed by means of the polymerase chain reactio n for the presence of bacterial deoxyribonucleic acid indicative of in fection, Synovial fluid specimens were processed using a rapid bacteri al lysis and extraction protocol, subjected to polymerase chain reacti on amplification using universal bacterial primers, and polymerase cha in reaction products analyzed by deoxyribonucleic acid hybridization m ethodology, Polymerase chain reaction testing on preoperative aspirate s yielded 32 specimens positive for bacterial infection, Standard micr obiologic culturing assays performed on the same samples gave 6 positi ve bacterial infection tests; intraoperative culturing identified 9 ad ditional infected specimens, All culture positive specimens were polym erase chain reaction positive; in contrast, there were no false polyme rase chain reaction positives in 21 negative control specimens obtaine d from aseptic joints, The synovial fluid processing protocol and poly merase chain reaction analysis can be performed with a minimum of time and may provide greater sensitivity than standard diagnostic tests. I n view of the high incidence of false negative test results from stand ard microbiologic assays of synovial fluid specimens, the use of molec ular biology based bacterial detection methodology should provide an a dditional, or alternative, assay to identify infected patient specimen s.