Prosthetic Joint Infection Diagnosis

Criteria for Diagnosis of Prosthetic Joint Infection

January 2010

The pathogenesis of Prosthetic Joint Infection involves the formation of microbial biofilms.  Bacteria, typically inoculated at the time of implantation, adhere to the implant and enter into a phenotypically unique, biofilm state in which they are relatively protected from conventional antimicrobial agents and the host immune system.  In this biofilm state, they grow slowly and elaborate an extracellular polymeric matrix.  As mentioned, in the biofilm state, they are relatively resistant to antimicrobial agents and the host immune system.  However, the immune system is attracted to the site of infection, and this can result in destruction of tissues surrounding the prosthesis and the finding, for example, of acute inflammation in periprosthetic tissues.

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Jump to section:

• Introduction
• Total Hip and Knee Replacement Procedures United States 1990-2006
• Body Diagram
• Prosthetic Hip and Knee Infections United States 1990-2004
• Surgical Management of Prosthetic Hip or Knee Infection
• Common Causes Hip and Knee Arthroplasty Infection
• Unusual Causes of Prosthetic Joint Infection³
• Diagram
• Criteria for Diagnosis of Prosthetic Joint Infection
• Prosthetic Joint Infection Clinical Presentation
• C-Reactive Protein Erythrocyte Sedimentation Rate
• C-Reactive Protein Erythrocyte Sedimentation Rate
• Images
• ¹⁸F-fluoro-2-deoxyglucose Positron Emission Tomography/Computed Tomography Increased Activity Around the Bone-Prosthesis Interface
• Synovial Fluid Leukocyte/Differential Prosthetic Knee
• Studies of Intrasurgical Frozen-Section Histopathologic Findings of Acute Inflammation in Prosthetic Joint Infection Diagnosis
• Prospective Vortexing/Sonication Clinical Study Hip or Knee Implants⁶
• Staphylococcus epidermidis Biofilm on Polycarbonate Coupons Scanning Electron Microscopy
• Periprosthetic Tissue and Sonicate Fluid Culture
• Prospective Vortexing/Sonication Clinical Study Hip or Knee Implants⁶
• Definition of Prosthetic Hip and Knee Infection
• Number of Microorganisms Detected by Sonicate Fluid Culture
• Results Prosthetic Hip or Knee Infection
• Effect of Preoperative Antimicrobial Therapy on Culture Sensitivity in Patients with Prosthetic Hip or Knee Infection
• Diagram
• Prospective Clinical Study Shoulder Implants
• Prospective Clinical Study Shoulder Implants
• Definition of Definite Prosthetic Shoulder Infection
• Prospective Clinical Study Shoulder Implants
• Shoulder Arthroplasty Infection
• Acknowledgments
• References
• Questions?
• Disclosure