Diagnosis of Periprosthetic Joint Infection - An Algorithm Based Approach

Abstract Background Periprosthetic joint infection (PJI) remains one of the most challenging and devastating modes of failure following total hip and knee arthroplasty. Despite the profound urgency and impact of PJI on an individual and societal basis, historically, there have not been standardized...

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Bibliographic Details
Published in:The Journal of arthroplasty 2017-07, Vol.32 (7), p.2047-2050
Main Authors: Ting, Nicholas T., MD, Della Valle, Craig J., MD
Format: Article
Language:English
Subjects:
AAHKS symposium
Aged
Algorithms
Arthritis, Infectious - diagnosis
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Knee - adverse effects
Blood Sedimentation
C-Reactive Protein - analysis
complications
diagnosis
Female
Humans
Intraoperative Care
Male
Orthopedics
periprosthetic joint infection
Prosthesis-Related Infections - blood
Prosthesis-Related Infections - diagnosis
Prosthesis-Related Infections - etiology
Surgeons
Synovial Fluid - cytology
total joint arthroplasty
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Summary:Abstract Background Periprosthetic joint infection (PJI) remains one of the most challenging and devastating modes of failure following total hip and knee arthroplasty. Despite the profound urgency and impact of PJI on an individual and societal basis, historically, there have not been standardized definitions of and diagnostic algorithms for infection following total joint arthroplasty. Methods In a recent symposium, the American Academy of Hip and Knee Surgeons (AAHKS) put forth a standardized approach to the prevention, diagnosis and management of the patient with a suspected PJI. Results This review article summarizes these findings, and reviews the algorithmic approach to diagnosis of periprosthetic joint infection. Conclusion The diagnosis of PJI is easily made in our experience in 90% of patients by getting an ESR and CRP followed by selective aspiration of the joint if these values are elevated or if the clinical suspicion is high. Synovial fluid obtained should be sent for a synovial fluid WBC count, differential and cultures.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2017.02.070