Lithuanian University of Health Sciences
Although a relatively rare complication, the incidence and prevalence of prosthetic joint infections (PJI) is certainly rising. This is mainly due to the number of arthroplasties performed each year and our ability to capture more cases. There is currently no consensus in the optimal diagnosis and management of the infected total hip arthroplasty. Various management techniques have been described in literature.
This review is a summary of the literature in diagnosing prosthetic joint infections (PJI) including next generation sequencing. An in-depth critical analysis of the biomarkers and the novel tests available in the market is reviewed including the evolving nature of the diagnostic criteria for PJI. The key issues in managing infected THA are identified.
Methods: The PubMed, Embase, and Cochrane Library databases were searched for relevant studies published before 2015.
Results: From collected data it appears that microbiologic and histologic tissue/fluid analysis is the key to diagnosing PJI. A positive culture result should still be the gold standard in diagnosing prosthetic joint infection. There is a good role for both debridement with antibiotics and implant retention and one stage revision procedures in the appropriately selected patient and should be used judiciously.
Conclusion: Prosthetic joint infection still poses a real challenge in arthroplasty. It may soon be the most leading cause of revision surgery. Unfortunately, registry data does not allow us to fully investigate and comprehend success or failure of the various modalities as not everyone undergoes a revision procedure following a diagnosis of PJI.
Keywords: Periprostetic infection, total hip arhtroplasty, periprostetic infection management.