Abstract: Objective To explore the value of detecting bacterial 16S rRNA with 23S rRNA in the diagnosis of periprosthetic joint
infection (PJI). Methods A prospective study was conducted among 67 patients with previous total hip arthroplasty (THA)
undergoing a reoperation for infection (23 patients) or aseptic loosening (44 patients). Bacterial 16S rRNA and 23S rRNA in the
interface membrane were detected by real-time PCR and their value in diagnosis of PJI was assessed. Results The 16S rRNA
and 23S rRNA showed no significant difference in their power in the diagnosis of PJI. The detection of 16S rRNA/23S rRNA
showed a higher sensitivity and a greater negative predictive value in PJI diagnosis than the detection of 16S rRNA+23S rRNA
(95.7% vs 52.2%, P<0.01; 97.6% vs 79.6%, P=0.01). The specificity, positive predictive value, and accuracy of the 4 diagnostic
strategies were not significantly different. Conclusion The diagnostic power of 16S rRNA and 23S rRNA was similar in
detecting PJI. Compared with the diagnostic strategy with 16S rRNA+ 23S rRNA, 16S rRNA/23S rRNA is more sensitive in
detecting PJI.