Science Letters

A Conspectus on the Diagnosis and Treatment of Periprosthetic Joint Infection

Uzair Masood, Liming Wang*, Qingqiang Yao, Qiangrong Gu, Mujtaba Ansari, Xiang Zhang, Shuai Liu, Umair Masood

Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, China

Abstract

Periprosthetic joint infection (PJI) holds a desolating complication sub-sequential to arthroplasty and is affiliated with consequential patient morbidity. It is roughly classified as early post-operative acute hematogenous and late chronic infection. There is an increase in the number of PJIs in males in comparison to females and in smokers compared to non-smokers. The organisms such Staphylococcus spp., Mycobacterium spp., Candida spp. and ?-hemolytic Streptococci spp. were found to be associated with PJI. According to some studies, S. aureus was noted to be the most common bacterium responsible for PJIs. The accurate preoperative, postoperative and intraoperative infection diagnosis is extremely important. For the diagnosis of deep implant infection, usually, integration of patient's physical examination, history, laboratory examination and joint aspiration are enough. According to many studies for diagnosing the infection of knee and hip arthroplasty, C-reactive protein level and erythrocyte sedimentation rate are ad hoc (precise) and responsive. To treat PJI's, there are many possible treatment methods, but the protocols are not meticulously followed. For early PJI, the universal treatments of choice are debridement, antibiotics, irrigation and retention of the prosthesis. There are various definitions and classifications given for ruling out PJI's. In many studies, the diversity of treatment and diagnosis is a restriction; hence PJI's outstanding treatment endures ambiguous. Further, the antibiotic-resistant Mycobacterium also makes it more challenging for the surgeons. This review describes the summary of diagnostic tools and treatments of PJI in use.