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. 2024 Jun 30:16:120308.
doi: 10.52965/001c.120308. eCollection 2024.

An overview of the current diagnostic approach to Periprosthetic Joint Infections

Talal Al-Jabri  1 , Mohamed Ridha  2 , Matthew J Wood  2 , Babar Kayani  3 , Chethan Jayadev  4 , Robert Allan McCulloch  2 , Emil Schemitsch  5
Affiliations

An overview of the current diagnostic approach to Periprosthetic Joint Infections

Talal Al-Jabri et al. Orthop Rev (Pavia). .

Abstract

The diagnosis of periprosthetic joint infections (PJI) presents a formidable challenge to orthopaedic surgeons due to its complex and diverse manifestations. Accurate diagnosis is of utmost importance, as even mild pain following joint replacement surgery may indicate PJI in the absence of a definitive gold standard diagnostic test. Numerous diagnostic modalities have been suggested in the literature, and international societies have continually updated diagnostic criteria for this debilitating complication. This review article aims to comprehensively examine the latest evidence-based approaches for diagnosing PJI. Through a thorough analysis of current literature, we explore promising diagnostic strategies that have demonstrated effectiveness in identifying PJI. These strategies encompass the utilization of laboratory markers, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), alongside imaging techniques such as magnetic resonance imaging (MRI) and leukocyte scintigraphy. Additionally, we highlight the importance of synovial fluid analysis, including the potential role of alpha-defensin as a biomarker, and examine evolving international diagnostic criteria to standardize and improve diagnostic accuracy.

Keywords: 2 stage revision; EBJIS; MSIS; arthroplasty; diagnosis; periprosthetic joint infections; revision; total hip replacement; total knee replacement.

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Conflict of interest statement

The authors declare that they do not have any competing interests

Figures

Figure 1.
Figure 1.. Sinus tract communicating with prosthesis.
Figure 3.
Figure 3.. MSIS 2018 criteria based on recommendations by Parvizi et al.
None
See this image and copyright information in PMC

References

    1. Reed M, Brittain R, Dawson-bowling S., et al. 2022National Joint Registry 19th Annual Report 2022. - PubMed
    1. Periprosthetic joint infection. Kapadia B.H., Berg R.A., Daley J.A., Fritz J., Bhave A., Mont M.A. 2016Lancet. 387(10016):386–394. doi: 10.1016/S0140-6736(14)61798-0. doi: 10.1016/S0140-6736(14)61798-0. - DOI - DOI - PubMed
    1. A financial analysis of revision hip arthroplasty: the economic burden in relation to the national tariff. Vanhegan I. S., Malik A. K., Jayakumar P., Islam S. U., Haddad F. S. 2012J Bone Joint Surg Br. 94(5):619–623. doi: 10.1302/0301-620X.94B5.27073. - DOI - PubMed
    1. Mortality During Total Hip Periprosthetic Joint Infection. Natsuhara K. M., Shelton T. J., Meehan J. P., Lum Z. C. 2019J Arthroplasty. 34(7S):S337–S342. doi: 10.1016/j.arth.2018.12.024. doi: 10.1016/j.arth.2018.12.024. - DOI - DOI - PubMed
    1. Definition of periprosthetic joint infection. Parvizi J., Gehrke T. 2014J Arthroplasty. 29(7):1331. doi: 10.1016/j.arth.2014.03.009. doi: 10.1016/j.arth.2014.03.009. - DOI - DOI - PubMed

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