{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:44:58Z","timestamp":1787755498968,"version":"build-2784847793"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2019,1,16]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>As the number of arthroplasties performed increases, periprosthetic joint infection (PJI) represents a common and challenging problem. The Musculoskeletal Infection Society (MSIS) recommends diagnosing PJI according to its guidelines. The aim of the current study was to assess whether fluorescence in situ hybridization (FISH) analysis of formalin-fixed paraffin-embedded periprosthetic membranes can successfully improve the diagnosis of infection in patients with orthopaedic implants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively analyzed 88 periprosthetic membranes of joint prostheses using FISH analysis according to a standard protocol, with a probe targeting a sequence found in most bacteria. We compared the results with routine clinical classification according to the guidelines of the MSIS, microbiological culture, and histopathological classification according to Morawietz and Krenn. We additionally performed FISH analysis using 2 species-specific probes for several culture-positive cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      FISH successfully detected bacteria in 38 (95%) of 40 periprosthetic membranes that were rated positive by clinical classification. FISH results compared with clinical classification demonstrated a sensitivity of 95% (95% confidence interval [CI], 83.08% to 99.39%), a specificity of 85.42% (95% CI, 72.24% to 93.93%), a positive predictive value of 84.44% (95% CI, 70.55% to 93.50%), and a negative predictive value of 95.35% (95% CI, 84.19% to 99.43%). FISH results compared with histopathological classification demonstrated a sensitivity of 95.12% (95% CI, 83.47% to 99.40%), a specificity of 87.23% (95% CI, 74.26% to 95.17%), a positive predictive value of 86.67% (95% CI, 73.21% to 94.95%), and a negative predictive value of 95.35% (95% CI, 84.19% to 99.43%). We successfully detected\n                      <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      with species-specific FISH probes in all cases that were positive for these respective bacteria by microbiological culture.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>FISH-based diagnosis of PJI is feasible and can be used as an additional diagnostic criterion. FISH not only can detect bacteria in periprosthetic membranes but can also differentiate pathogens at the species level. FISH represents a fast and reliable tool for detecting PJI in periprosthetic membranes, especially in combination with clinical and histopathological classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Diagnostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.18.00243","type":"journal-article","created":{"date-parts":[[2019,1,29]],"date-time":"2019-01-29T22:33:01Z","timestamp":1548801181000},"page":"e5","source":"Crossref","is-referenced-by-count":9,"title":["Fluorescence in Situ Hybridization (FISH) for the Diagnosis of Periprosthetic Joint Infection in Formalin-Fixed Paraffin-Embedded Surgical Tissues"],"prefix":"10.2106","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9292-7660","authenticated-orcid":false,"given":"Torsten","family":"Lippmann","sequence":"first","affiliation":[{"name":"Institute of Pathology (T.L., P.B., M.K., F.L., and D.J.) and Department of Orthopaedic Surgery (M.E.), Hannover Medical School (MHH), Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3673-7779","authenticated-orcid":false,"given":"Peter","family":"Braubach","sequence":"additional","affiliation":[{"name":"Institute of Pathology (T.L., P.B., M.K., F.L., and D.J.) and Department of Orthopaedic Surgery (M.E.), Hannover Medical School (MHH), Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0909-9097","authenticated-orcid":false,"given":"Max","family":"Ettinger","sequence":"additional","affiliation":[{"name":"Institute of Pathology (T.L., P.B., M.K., F.L., and D.J.) and Department of Orthopaedic Surgery (M.E.), Hannover Medical School (MHH), Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Kuehnel","sequence":"additional","affiliation":[{"name":"Institute of Pathology (T.L., P.B., M.K., F.L., and D.J.) and Department of Orthopaedic Surgery (M.E.), Hannover Medical School (MHH), Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1191-4855","authenticated-orcid":false,"given":"Florian","family":"Laenger","sequence":"additional","affiliation":[{"name":"Institute of Pathology (T.L., P.B., M.K., F.L., and D.J.) and Department of Orthopaedic Surgery (M.E.), Hannover Medical School (MHH), Hannover, Germany"},{"name":"Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (Deutsches Zentrum f\u00fcr Lungenforschung [DZL]), Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5251-2281","authenticated-orcid":false,"given":"Danny","family":"Jonigk","sequence":"additional","affiliation":[{"name":"Institute of Pathology (T.L., P.B., M.K., F.L., and D.J.) and Department of Orthopaedic Surgery (M.E.), Hannover Medical School (MHH), Hannover, Germany"},{"name":"Biomedical 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