**3.2.3 Periprosthetic tissue biopsies**

Analysis of tissue biopsies offers the advantage that multiple samples can be obtained from different locations within the suspicious area. Repeated isolation of bacteria (e. g., isolation of the same organism in at least 2 tissue samples) increases the probability of infection. Thus, there are several reports in which higher sensitivity of tissue culture compared with synovial fluid culture is observed (Fink et al., 2008; Meermans & Haddad, 2010; Roberts et al., 1992; Sadiq et al., 2005; Williams et al., 2004).
