Progress in diagnosis of periprosthetic joint infection after arthroplasty
Yang Fei1， Wang Guodong2， Zhao Xiaowei2
1Jining Medical University， Jining 272067， China; 2Department of Orthopedics， the Affiliated Hospital of Jining Medical University， Jining 272029, China
Abstract：Periprosthetic joint infection (PJI) is one of the catastrophic complications of patients undergoing joint replacement and has become the primary cause of joint replacement revision surgery. At present, diagnosis of PJI still lacks golden standard because of the limited sensitivity and specificity of laboratory and imaging diagnostic methods, such as erythrocyte sedimentation rate (ESR) and C-reactive protein(CRP). Synovial fluid biomarkers such as leukocyte esterase and alphadefensins have extremely high diagnostic utility and have attracted increasing attention. The concentration of procalcition and IL-6 in joint fluid has higher diagnostic value than that in serum. Leukocyte scintigraphy, anti-granulocyte scintigraphy and 18fluoro-fluorodeoxyglucose imaging techniques perform well but they are still not widely applied. Molecular biology techniques such as second-generation sequencing have become the focus of current research due to the ability to detect DNA in culture-negative pathogens and being unaffected by previous antibiotics administration. This article aims to provide more sensitive and specific diagnostic methods to get early diagnosis and early treatment for patients with PJI, so as to reduce patients′ pain and costs.
