Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;103-B(1):18-25.
doi: 10.1302/0301-620X.103B1.BJJ-2020-1381.R1.

The EBJIS definition of periprosthetic joint infection

Martin McNally  1 , Ricardo Sousa  2 , Marjan Wouthuyzen-Bakker  3 , Antonia F Chen  4 , Alex Soriano  5 , H Charles Vogely  6 , Martin Clauss  7 , Carlos A Higuera  8 , Rihard Trebše  9
Affiliations

The EBJIS definition of periprosthetic joint infection

Martin McNally et al. Bone Joint J. 2021 Jan.

Abstract

Aims: The diagnosis of periprosthetic joint infection (PJI) can be difficult. All current diagnostic tests have problems with accuracy and interpretation of results. Many new tests have been proposed, but there is no consensus on the place of many of these in the diagnostic pathway. Previous attempts to develop a definition of PJI have not been universally accepted and there remains no reference standard definition.

Methods: This paper reports the outcome of a project developed by the European Bone and Joint Infection Society (EBJIS), and supported by the Musculoskeletal Infection Society (MSIS) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Implant-Associated Infections (ESGIAI). It comprised a comprehensive review of the literature, open discussion with Society members and conference delegates, and an expert panel assessment of the results to produce the final guidance.

Results: This process evolved a three-level approach to the diagnostic continuum, resulting in a definition set and guidance, which has been fully endorsed by EBJIS, MSIS, and ESGIAI.

Conclusion: The definition presents a novel three-level approach to diagnosis, based on the most robust evidence, which will be useful to clinicians in daily practice. Cite this article: Bone Joint J 2021;103-B(1):18-25.

Keywords: Arthroplasty; Definition; Diagnosis; EBJIS; Infection; Prosthetic joint infection.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
EBJIS criteria for the diagnosis of clinically-suspected periprosthetic joint infection.
See this image and copyright information in PMC

References

    1. Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J Arthroplasty. 2012;27(8 Suppl):61–65. - PubMed
    1. Ibrahim MS, Twaij H, Haddad FS. Two-stage revision for the culture-negative infected total hip arthroplasty : A comparative study. Bone Joint J. 2018;100-B(1 Supple A):3–8. - PMC - PubMed
    1. Middleton R, Khan T, Alvand A. Update on the diagnosis and management of prosthetic joint infection in hip and knee arthroplasty. Bone & Joint 360. 2019;8(4):5–13.
    1. Parvizi J, Zmistowski B, Berbari EF, et al. . New definition for periprosthetic joint infection: from the Workgroup of the musculoskeletal infection Society. Clin Orthop Relat Res. 2011;469(11):2992–2994. - PMC - PubMed
    1. Parvizi J, Gehrke T, et al. . International consensus group on periprosthetic joint I. Definition of periprosthetic joint infection. J Arthroplasty. 2014;29(7):1331. - PubMed