Current Clinical Methods for Detection of Peri-Prosthetic Joint Infection

Abstract

Background: Currently, one of the most pressing problems in the field of orthopedic surgery is peri-prosthetic joint infection [PJI]. While there are numerous ways to detect PJI, current clinical detection methods differ across institutions and have varying criteria and protocols. Some of these methods include the Modified Musculoskeletal Infection Society system, culturing, polymerase chain reaction, the determination of the presence of certain biomarkers, testing for the presence of alpha defensin peptides, and leukocyte level testing. Methods: This review summarizes the most recent publications in the field of PJI detection to highlight current strengths as well as provide future directions to find the system for the quickest, cost-effective, and most accurate way to diagnose these types of infections. Results: The results of this literature review suggest that, while each method of diagnosis has its advantages, each has various drawbacks as well. Current methods can be expensive, take days to weeks to complete, be prone to contamination, and can produce ambiguous results. Conclusions: The findings in this review emphasize the need for a more comprehensive and accurate system for diagnosing PJI. In addition, the specific comparison of advantages and drawbacks can be useful for researchers and clinicians with goals of creating new diagnostic tests for PJIs, as well as in clinical scenarios to determine the correct treatment for patients.

Thromboelastography parameters in diagnosing periprosthetic joint infection and predicting reimplantation timing

“…Periprosthetic joint infection (PJI), one of the most troublesome complications of total hip or knee arthroplasty, exacerbates the burden on the individual and health care system [ 1 – 4 ]. As the number of surgeries surged yearly, the total number of PJI patients increased [ 5 ].…”

Thromboelastography Performs Well for the Diagnosis of Periprosthetic Joint Infection.

“…Patients were excluded if one or more of the following situations exist: (1) Ultimately, 62 patients were included in this study: 23 in group A (patients undergoing revision arthroplasty for the treatment of PJI) and 39 in group B (patients receiving revision arthroplasty due to aseptic loosening). Eighty-three patients were excluded due to lacking needed data of the study (n = 55), deep vein thrombosis formation of lower limbs (n = 24), taking oral warfarin recently due to coronary stent implantation (n = 2), urinary tract infection (n = 1) and rheumatoid arthritis (n = 1).…”

“…Periprosthetic joint infection (PJI) is one of the most troublesome complications of total hip or knee arthroplasty, it exacerbates the burdens of the individual and health care system [1][2][3][4]. As the number of surgeries has surged year by year, the totality of PJI patients increased subsequently [5].…”

Application of Nucleic Acid-Based Strategies to Detect Infectious Pathogens in Orthopaedic Implant-Related Infection

“…1). This also has been applied to musculoskeletal infection (see Appendix Supplemental Table 1) 38,39 . In multiplex qPCR, several PCR reactions for specific targets are performed in the same reaction mix.…”