Clinical Orthopaedics and Related Research

, Volume 467, Issue 5, pp 1360–1364 | Cite as

Improved Detection of Biofilm-formative Bacteria by Vortexing and Sonication: A Pilot Study

  • Hideo Kobayashi
  • Margret Oethinger
  • Marion J. Tuohy
  • Gary W. Procop
  • Thomas W. BauerEmail author
Original Article


Bacteria such as staphylococci commonly encountered in orthopaedic infections form biofilms and adhere to bone implants and cements. Various methods to disrupt the biofilm and enhance bacterial detection have been reported. We will describe the effectiveness of vortexing and sonication to improve the detection of biofilm-formative bacteria from polymethylmethacrylate by conventional quantitative bacterial culture and real-time quantitative PCR. We used a single biofilm-formative Staphylococcus aureus strain and 20 polymethylmethacrylate coupons as an in vitro biofilm model; four coupons were used for each of two control groups or three experimental sonication times (1, 5, and 30 minutes). Vortexing the cement without sonication increased the yield of adherent bacteria to a considerable extent. The combination of vortexing and sonication further enhanced the yield regardless of the duration of sonication. Quantitative conventional cultures correlated with quantitative PCR assay. The combination of vortexing and sonication to disrupt the bacterial biofilm followed by quantitative PCR and/or culture seems to be a sensitive method for detecting bacteria adherent to bone cement.


PMMA Bone Cement Aseptic Loosening Sonication Time Prosthetic Joint Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Dr. Gerri S. Hall for assistance in preparing the manuscript. We also are grateful to Benjamin Nutter for advice on the statistical analysis.


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Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • Hideo Kobayashi
    • 1
    • 2
  • Margret Oethinger
    • 1
  • Marion J. Tuohy
    • 1
  • Gary W. Procop
    • 1
  • Thomas W. Bauer
    • 1
    • 2
    • 3
    Email author
  1. 1.Institute of Pathology and Laboratory MedicineThe Cleveland ClinicClevelandUSA
  2. 2.Orthopaedic and Rheumatologic InstituteThe Cleveland ClinicClevelandUSA
  3. 3.Departments of Anatomic Pathology, Orthopaedic Surgery, and the Spine InstituteL-25, The Cleveland Clinic FoundationClevelandUSA

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