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What role do periodontal pathogens play in osteoarthritis and periprosthetic joint infections of the knee?
Journal article   Peer reviewed

What role do periodontal pathogens play in osteoarthritis and periprosthetic joint infections of the knee?

Garth D Ehrlich, Fen Z Hu, Nicholas Sotereanos, Jeffrey Sewicke, Javad Parvizi, Peter L Nara and Carla Renata Arciola
Journal of applied biomaterials & functional materials, v 12(1), pp 13-20
12 Jun 2014
DOI: https://doi.org/10.5301/jabfm.5000203
PMID: 24921460
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Enterococcus faecalis Treponema denticola Arthroplasty, Replacement, Knee - adverse effects Periodontitis - microbiology Humans Gram-Negative Bacterial Infections - genetics Male Gram-Positive Bacterial Infections - etiology Periodontitis - genetics Osteoarthritis - genetics Gram-Negative Bacterial Infections - microbiology Postoperative Complications - microbiology Gram-Positive Bacterial Infections - microbiology Postoperative Complications - genetics Gram-Positive Bacterial Infections - genetics RNA, Bacterial - genetics RNA, Ribosomal, 16S - genetics Female Knee Prosthesis - microbiology Gram-Negative Bacterial Infections - etiology Osteoarthritis - microbiology Osteoarthritis - etiology
Through the use of polymerase chain reaction (PCR)-electron spray ionization (ESI)-time of flight (TOF)-mass spectrometry (MS), we identified multiple periodontal pathogens within joint tissues of individuals undergoing replacement arthroplasties of the knee. The most prevalent of the periodontal pathogens were Treponema denticola and Enterococcus faecalis, the latter of which is commonly associated with apical periodontitis. These findings were unique to periprosthetic joint infections (PJI) of the knee and were never observed for PJIs of other lower extremity joints (hip and ankle) or upper extremity joints (shoulder and elbow). These data were confirmed by multiple independent methodologies including fluorescent in situ hybridization (FISH) which showed the bacteria deeply penetrated inside the diseased tissues, and 454-based deep 16S rDNA sequencing. The site-specificity, the tissue investment, and the identical findings by multiple nucleic-acid-based techniques strongly suggests the presence of infecting bacteria within these diseased anatomic sites. Subsequently, as part of a control program using PCR-ESI-TOF-MS, we again detected these same periodontal pathogens in aspirates from patients with osteoarthritis who were undergoing primary arthroplasty of the knee and thus who had no history of orthopedic implants. This latter finding raises the question of whether hematogenic spread of periodontal pathogens to the knee play a primary or secondary-exacerbatory role in osteoarthritis.

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25 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Biophysics
Engineering, Biomedical
Materials Science, Biomaterials
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