Diagnostics in Late Periprosthetic Infections-Challenges and Solutions

The rising number of arthroplasties is combined with a rising number of periprosthetic joint infections, which leads to life-concerning consequences for the patients, including extended antibiotic treatment, further surgery and increased mortality. The heterogeneity of the symptoms and inflammatory...

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Bibliographic Details
Published in:Antibiotics (Basel) 2024-04, Vol.13 (4), p.351
Main Authors: Sax, Florian Hubert, Hoyka, Marius, Blersch, Benedikt Paul, Fink, Bernd
Format: Article
Language:English
Subjects:
Algorithms
Availability
Biofilms
Biopsy
Care and treatment
Clinical medicine
Comorbidity
diagnosis
Diagnostic systems
Fistula
Health aspects
Heterogeneity
Implants, Artificial
Infection
Infections
Infectious diseases
Inflammation
Inflammatory response
Joint diseases
Joint surgery
Mortality
Parameters
Patients
periprosthetic joint infection
Prostheses
Prosthesis
review
Scintigraphy
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Summary:The rising number of arthroplasties is combined with a rising number of periprosthetic joint infections, which leads to life-concerning consequences for the patients, including extended antibiotic treatment, further surgery and increased mortality. The heterogeneity of the symptoms and inflammatory response of the patients due to, e.g., age and comorbidities and the absence of a single diagnostic test with 100% accuracy make it very challenging to choose the right parameters to confirm or deny a periprosthetic joint infection and to establish a standardized definition. In recent years, additional diagnostic possibilities have emerged primarily through the increasing availability of new diagnostic methods, such as genetic techniques. The aim of the review is to provide an overview of the current state of knowledge about the various tests, including the latest developments. The combination of different tests increases the accuracy of the diagnosis. Each physician or clinical department must select the tests from the available methods that can be best implemented for them in organizational and technical terms. Serological parameters and the cultivation of the samples from aspiration or biopsy should be combined with additional synovial tests to create an accurate figure for the failure of the prosthesis, while imaging procedures are used to obtain additional information for the planned therapeutic procedure.
ISSN:2079-6382
2079-6382
DOI:10.3390/antibiotics13040351