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Total joint replacement (TJR) surgery is one of the most successful operations for end-stage arthritic disorders and fractures around the joint. However, periprosthetic joint infection (PJI) is a concerning complication after TJR and affects postoperative functional outcomes. Diagnosis for PJI is the first step leading to definite treatment. In clinical practice, the authors found incomplete laboratory studies and misinterpretation in some diagnostic tests, especially the recently proposed tools. Incomplete investigations delay the diagnosis and appropriate management, impact poor functional results, and increase morbidity. Therefore, we reviewed the current evidence of PJI-related risk factors, clinical clues of signs and symptoms, the common pathogen, and PJI diagnosis criteria. This clinical practice guideline is proposed for Srinagarind Hospital’s physicians, orthopaedic residents, and other health care providers for guidance on the PJI diagnosis.
2. Malinzak RA, Ritter MA, Berend ME, Meding JB, Olberding EM, Davis KE. Morbidly obese, diabetic, younger, and unilateral joint arthroplasty patients have elevated total joint arthroplasty infection rates. J Arthroplasty 2009; 24: 84–88.
3. Namba RS, Inacio MCS, Paxton EW. Risk factors associated with deep surgical site infections after primary total knee arthroplasty: an analysis of 56,216 knees. J Bone Joint Surg Am 2013; 95: 775–782.
4. Jämsen E, Nevalainen P, Eskelinen A, Huotari K, Kalliovalkama J, Moilanen T. Obesity, diabetes, and preoperative hyperglycemia as predictors of periprosthetic joint infection: a single-center analysis of 7181 primary hip and knee replacements for osteoarthritis. J Bone Joint Surg Am 2012; 94: e101.
5. Kurtz SM, Ong KL, Lau E, Bozic KJ, Berry D, Parvizi J. Prosthetic joint infection risk after TKA in the Medicare population. Clin Orthop 2010; 468: 52–56.
6. Berbari EF, Hanssen AD, Duffy MC, Steckelberg JM, Ilstrup DM, Harmsen WS, et al. Risk factors for prosthetic joint infection: case-control study. Clin Infect Dis 1998; 27: 1247–1254.
7. Enayatollahi MA, Parvizi J. Diagnosis of infected total hip arthroplasty. Hip Int J Clin Exp Res Hip Pathol Ther 2015; 25: 294–300.
8. Poss R, Thornhill TS, Ewald FC, Thomas WH, Batte NJ, Sledge CB. Factors influencing the incidence and outcome of infection following total joint arthroplasty. Clin Orthop 1984; 182: 117–126.
9. Parvizi J, Fassihi SC, Enayatollahi MA. Diagnosis of periprosthetic joint infection following hip and knee arthroplasty. Orthop Clin North Am 2016; 47: 505–515.
10. Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, et al. New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop 2011; 469: 2992–2994.
11. Parvizi J, Gehrke T, Chen AF. Proceedings of the international consensus on periprosthetic joint infection. Bone Jt J 2013; 95-B: 1450–1452.
12. Parvizi J, Tan TL, Goswami K, Higuera C, Della Valle C, Chen AF, et al. The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplasty 2018; 33: 1309-1314. e2.
13. Shohat N, Bauer T, Buttaro M, Budhiparama N, Cashman J, Della Valle CJ, et al. Hip and knee section, what is the definition of a periprosthetic joint infection (PJI) of the knee and the hip? can the same criteria be used for both joints?: proceedings of international consensus on orthopedic infections. J Arthroplasty 2019; 34: S325–327.