Periprosthetic Joint Infection

In this blog, Victoria Tam, PA-S, discusses the etiology, risk factors, diagnosis and treatment of PJI. She includes a clinical case study to demonstrate how a prosthetic joint infection is diagnosed and managed.

A recent study adds to growing data showing that oral antibiotics are as good as IV antibiotics in periprosthetic joint infection, and the data show that an early switch can be considered in the right scenario.

Results from the Musculoskeletal Infection Society Annual Meeting showed the 2018 International Consensus Meeting definition for periprosthetic joint infection had poor accuracy in identifying reimplantations that did or did not fail.

In diagnosing periprosthetic joint infection during two-stage exchange, results showed C-reactive protein had the highest diagnostic utility, while erythrocyte sedimentation rate and synovial biomarkers had acceptable diagnostic utility.

Debridement, antibiotics and implant retention was more successful when performed by a fellowship-trained adult joint reconstruction surgeon compared with a non-fellowship-trained surgeon, according to presented results.

Results showed septic knee revisions, specifically explantations, were more expensive and had longer length of stay vs. aseptic revisions. Single-stage reimplantation had the best societal value for periprosthetic joint infection treatment.

Onodera’s prognostic nutritional index may be a valid and excellent predictor of complications after total knee arthroplasty, according to results presented at the Musculoskeletal Infection Society Annual Meeting.

Debridement, antibiotics and implant retention yielded a high failure rate when used to treat periprosthetic joint infection after hemiarthroplasty, according to results presented at the Musculoskeletal Infection Society Annual Meeting.

Results showed septic hip revision was more expensive and had a longer length of stay compared with aseptic revision. Single-stage reimplantation presented the best value for society for periprosthetic joint infection treatment.

Results presented here showed ultrasound-guided aspiration was more commonly successful and more sensitive in diagnosing periprosthetic joint infections in patients who underwent total hip arthroplasty.