Hip and Knee Section, What is the Definition of a Periprosthetic Joint Infection (PJI) of the Knee and the Hip? Can the Same Criteria be Used for Both Joints?: Proceedings of International Consensus on Orthopedic Infections

Early Debridement, antibiotics and implant retention (DAIR) in patients with suspected acute infection after hip or knee arthroplasty - safe, effective and without negative functional impact

“…Still, one must consider that during the entire study period there was no universal clear definition of PJI in the acute setting. Recently, a PJI definition was proposed by the latest ICM consensus that also aims to define acute infection (15) but in our view, this definition lacks enough evidence and just recently it has been shown that the proposed thresholds may be missing a large proportion of infected cases (16).…”

Periprosthetic joint infections after total hip replacement: an algorithmic approach

“…In a case of suspected THA infection, the patient should be promptly referred to the specialist hip team which utilises a multi-disciplinary approach in managing such infections as this is a specialised procedure and there is no role for simple incision and drainage or repetitive washouts which result in emergence of resistant microorganisms [5,8]. Clinical presentation (pain, fever, swelling, skin redness, discharging sinus), serologic testing (erythrocyte sedimentation rate [ESR] > 30 mm/h; C-reactive protein [CRP] > 10 mg/L), hip aspiration and biopsy with microbiology and cell count analyses help us diagnose PJI [8][9][10]. Definitive diagnosis however, is established when threeto-six specimens are sampled from different sites at the time of surgery (e.g., capsule, femur and acetabulum) and the same microorganism is cultured from at least two specimens [10][11][12][13].…”

“…Clinical presentation (pain, fever, swelling, skin redness, discharging sinus), serologic testing (erythrocyte sedimentation rate [ESR] > 30 mm/h; C-reactive protein [CRP] > 10 mg/L), hip aspiration and biopsy with microbiology and cell count analyses help us diagnose PJI [8][9][10]. Definitive diagnosis however, is established when threeto-six specimens are sampled from different sites at the time of surgery (e.g., capsule, femur and acetabulum) and the same microorganism is cultured from at least two specimens [10][11][12][13]. The extent of infection and the interval for which it has been present play a role in the choice of treatment and the chances for successful eradication of infection as follows:…”

Assessment of a Multiplex Serological Test for the Diagnosis of Prosthetic Joint Infection: a Prospective Multicentre Study

“…The alpha-defensin quick on-table lateral flow test (Synovasure, Zimmer Biomet, USA), proposing maximum specificity in a short time, has even been proposed as a perioperative confirmatory test for PJI [17]. However, some other studies should moderate the recent enthusiasm for these biomarkers, now considered as minor diagnostic criteria for PJI [6,8]. Kleist et al [18] recently showed that the performances of the synovial fluid alpha-defensin ELISA are insufficient to accurately diagnose PJI, especially due to coagulasenegative staphylococci [18].…”

“…The clinical Ivyspring International Publisher signs are non-specific when they include pain and inflammation in the absence of fever. The cornerstone for the diagnosis remains bacteriological culture of pre-and/or perioperative samples, which is considered as a major criterion by the Infectious Diseases Society of America (IDSA), the International Consensus on Orthopaedic Infections, and other European learned societies [4][5][6][7][8].…”