Title

Direct versus conventional sonication for the diagnosis of joint infection: A comparative study

Authors

Zahid Bashir¹, Heena Dixit Tiwari², Fazeena Karimalakuzhiyil Alikutty³, Rahul Tiwari^4,*, Deepak Sharma², Anil Managutti⁴ & Afroz Kalmee Syed⁵

Affiliation

¹Department of Orthopedics, Ortho One Hospital, Coimbatore, Tamil Nadu, India; ²Department of Medical Health Administration, Index Institute, Malwanchal University, Index City, Nemawar Road, Indore, Madhya Pradesh, India; ³Department of Preventive Dental Sciences, Ibn Sina National College for Medical Studies, Jeddah, Saudi Arabia; ⁴Department of Oral and Maxillofacial Surgery, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India; ⁵Department of Oral and Maxillofacial Pathology, Scientific Medical Writer, Writing and Publications, Tenali, Andhra Pradesh, India; *Corresponding author

Email

Zahid Bashir - E-mail: bzahid09@yahoo.co.uk
Heena Dixit Tiwari - E-mail: drheenatiwari@gmail.com
Fazeena Karimalakuzhiyil Alikutty - E-mail: fadil@ibnsina.edu.sa
Rahul Tiwari - E-mail: drrahulvctiwari@gmail.com
Deepak Sharma: Email: deepaksharma@yahoo.com
Anil Managutti - E-mail: dranilman12@gmail.com
Afroz Kalmee Syed - E-mail: afrozsyed05@gmail.com

Article Type

Research Article

Date

Received September 1, 2025; Revised September 30, 2025; Accepted September 30, 2025, Published September 30, 2025

Abstract

Periprosthetic joint infection (PJI) remains a major cause of revision arthroplasty, and accurate diagnostic methods are essential. In this comparative study of 196 revision cases (94 direct vs. 102 conventional sonication), 116 (59.2%) met criteria for PJI. Direct sonication achieved higher sensitivity (86.2%, 95% CI 78.3–92.0) compared with conventional sonication (70.7%, 95% CI 60.4–79.5; p < 0.01), while specificity was comparable (90.3% vs. 94.4%). Importantly, the time-to-positivity (TTP) was significantly shorter with direct sonication (median 2.1 days vs. 3.0 days; p = 0.002), particularly for Gram-positive organisms. These findings demonstrate that direct sonication enhances diagnostic yield, accelerates pathogen recovery, and supports its integration into standardized PJI diagnostic pathways for earlier targeted therapy.

Keywords

Periprosthetic joint infection, sonication, blood culture, biofilms, time-to-positivity.

Citation

Bashir et al. Bioinformation 21(9): 3321-3323 (2025)

Edited by

Akshaya Ojha

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.