Sonication of explanted prosthesis constitutes an element of microbiological diagnostics. The aim of performing this procedure is to remove biofilm and to increase sensitivity of diagnostics. Ultrasound used in medical purposes are low-frequency and low-intensity. With this wide range of frequency which can be used in sonication process it is necessary to find the golden mean between biofilm dislodging and planktonic bacteria sparing. The aim of this study was to determine the least harming low-intensity ultrasound frequency (35 kHz, 40 kHz or 53 kHz) used during sonication process with other parameters constant. Four bacteria species were examined: S. aureus, E. faecalis, E. coli, K. pneumoniae. Number of microbiological studies (n) for each group (g) counted 40 specimens (based on scheme 1 bacteria type - 4 groups, 40 studies each). A detailed analysis of gathered data was conducted. Based on study findings following conclusions were drawn. Sonication has a significant and negative impact on survival of sonicated planktonic bacteria. Part of bacteria in planktonic state are damaged/killed by ultrasound, which is demonstrated by lower CFU count in sonicated samples versus control group. Optimal ultrasound frequencies for sonication of S. aureus, P. aeruginosa and E. coli are 35 kHz and 40 kHz. Ultrasound frequencies used in sonication process (35 kHz, 40 kHz, 53 kHz) of E. coli showed same impact on bacteria survival. It is crucial to perform further assessment of ultrasound parameters on clinical effects of sonication used in PJI diagnostics.

Aims: Total knee arthroplasty in patients with fixed valgus deformity is a demanding procedure. The aim of this study was to compare the clinical results of using the lateral approach [LA] versus the medial approach [MA] in the treatment of fixed valgus knee deformities. Methods: This single-center study compared the results of 143 consecutive patients with fixed valgus deformity (mean 21.55° valgus, mean age 68.2 years) undergoing LA Total Knee Arthroplasty [TKA] to 50 patients (mean 16.58° valgus, mean age 67.2 years) undergoing MA TKA. The mean follow-up period was 5.1 years (2–10 years). Data was collected from operative notes, routine postoperative visits, and radiological findings. Apart from a radiological evaluation, patients were clinically assessed both pre- and postoperatively using the Knee Society Score [KSS]. Descriptive statistics together with the Kolmogorov-Smirnov test, the Student’s t-test for independent samples, and the Mann-Whitney U test were used. The level of significance in this study was α = 0.05. Results: In the LA group, the KSS Knee was significantly higher than in the MA group [85.31 vs. 77.42, respectively, p-value < 0.001]. The difference was also in the KSS total but with no statistical significance [155.17 vs. 149.22, p-value 0.087]. The surgery time in the LA group was shorter than in the MA group [81 vs. 91 min, respectively, p-value—0.002]. The complication rate after surgery was higher in the MA group than in the LA group (14% vs. 9%, respectively). Conclusions: The lateral approach is a good alternative to the standard medial parapatellar approach in the treatment of fixed valgus knee deformities. A higher postoperative KSS Knee, shorter surgery time, and similar complication rate make the lateral approach a valuable option for treating patients with osteoarthritis and fixed valgus knee deformity.

Periprosthetic joint infection (PJI) is a severe complication following total knee arthroplasty (TKA) and total hip arthroplasty (THA), associated with significantly increased patient morbidity and mortality. PJI remains the leading cause of early revision surgery after total joint arthroplasty and imposes a substantial financial burden on the healthcare system. In the United States, the incidence of PJI is estimated at 1–2% for primary THA and TKA procedures. Infections can arise from local spread from the skin or air, or through hematogenous seeding of the affected joint. Reducing the bacterial load at the surgical site is critical for preventing postoperative infections, and this goal is achieved through rigorous maintenance of perioperative sterility and appropriate antibiotic administration. Antibiotic prophylaxis is a cornerstone of infection prevention in arthroplasty and has been conclusively shown to lower the incidence of PJI. However, considerable variability and ongoing debate exist regarding the optimal route of antibiotic administration for infection prevention in THA and TKA. This review summarizes the current evidence on antibiotic strategies during primary total hip and knee arthroplasty, with the aim of informing perioperative management decisions among arthroplasty specialists and other clinicians involved in the care of these patients. This review will help guide perioperative decisions for arthroplasty specialists and will also serve as a valuable resource for general practitioners and infectious disease specialists who are involved in the care of patients who are about to undergo or have previously undergone a total joint arthroplasty procedure. This article is well-suited for publication in BMC Musculoskeletal Disorders because it addresses a major cause of morbidity and revision surgery in orthopaedic practice, aligning closely with the journal’s focus on musculoskeletal health and disease. By synthesizing current evidence on antibiotic prophylaxis in total joint arthroplasty, it offers practical guidance for clinicians, researchers, and policymakers seeking to improve surgical outcomes. The article’s multidisciplinary relevance, spanning orthopaedics, infectious disease, and perioperative care, fits the journal’s commitment to publishing research that bridges clinical practice and broader healthcare impacts.

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