New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society.
Javad Parvizi,Benjamin Zmistowski,Elie F. Berbari,Thomas W. Bauer,Bryan D. Springer,Craig J. Della Valle,Kevin L. Garvin,Michael A. Mont,Montri D. Wongworawat,Charalampos G. Zalavras +9 more
TLDR
Based on the proposed criteria, definite PJI exists when there is a sinus tract communicating with the prosthesis and a pathogen is isolated by culture from at least two separate tissue or fluid samples obtained from the affected prosthetic joint.Abstract:
Based on the proposed criteria, definite PJI exists when:
(1)
There is a sinus tract communicating with the prosthesis; or
(2)
A pathogen is isolated by culture from at least two separate tissue or fluid samples obtained from the affected prosthetic joint; or
(3)
Four of the following six criteria exist:
(a)
Elevated serum erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) concentration,
(b)
Elevated synovial leukocyte count,
(c)
Elevated synovial neutrophil percentage (PMN%),
(d)
Presence of purulence in the affected joint,
(e)
Isolation of a microorganism in one culture of periprosthetic tissue or fluid, or
(f)
Greater than five neutrophils per high-power field in five high-power fields observed from histologic analysis of periprosthetic tissue at ×400 magnification.
PJI may be present if fewer than four of these criteria are met.read more
Citations
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Journal ArticleDOI
Prosthetic Joint Infection
Aaron J. Tande,Robin Patel +1 more
TL;DR: The recently proposed consensus definitions of PJI and approaches to accurate diagnosis are reviewed in detail and an overview of the treatment and prevention of this challenging condition is provided.
Journal ArticleDOI
The 2018 Definition of Periprosthetic Hip and Knee Infection: An Evidence-Based and Validated Criteria.
Javad Parvizi,Timothy L. Tan,Karan Goswami,Carlos A. Higuera,Craig J. Della Valle,Antonia F. Chen,Noam Shohat +6 more
TL;DR: This study offers an evidence-based definition for diagnosing hip and knee PJI, which has shown excellent performance on formal external validation and compared to the established MSIS and the prior International Consensus Meeting definitions.
Journal ArticleDOI
Definition of periprosthetic joint infection.
Javad Parvizi,Thorsten Gehrke +1 more
Journal ArticleDOI
Periprosthetic Joint Infection Increases the Risk of One-Year Mortality
TL;DR: Surgeons must be cognizant of the systemic impact of periprosthetic joint infection and its major influence on fatal outcome in patients, and independent predictors of mortality included increasing age, higher Charlson Comorbidity Index, history of stroke, polymicrobial infections, and cardiac disease.
Journal ArticleDOI
Fracture-related infection: A consensus on definition from an international expert group
Willem-Jan Metsemakers,Mario Morgenstern,Martin A. McNally,Thomas Fintan Moriarty,I. McFadyen,Matthew Scarborough,Nicholas A. Athanasou,Peter E. Ochsner,Richard Kuehl,Michael J. Raschke,Olivier Borens,Zhao Xie,Steven Velkes,Sven Hungerer,Stephen L. Kates,Charalampos G. Zalavras,Peter V. Giannoudis,Robert Geoff Richards,Michiel H J Verhofstad +18 more
TL;DR: The intention of establishing this definition of FRI was to offer clinicians the opportunity to standardize clinical reports and improve the quality of published literature, and should be validated by prospective data collection in the future.
References
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Journal ArticleDOI
Sonication of Removed Hip and Knee Prostheses for Diagnosis of Infection
Andrej Trampuz,Kerryl E. Piper,Melissa J. Jacobson,Arlen D. Hanssen,Krishnan K. Unni,Douglas R. Osmon,Jayawant N. Mandrekar,Franklin R. Cockerill,James M. Steckelberg,James F. Greenleaf,Robin Patel +10 more
TL;DR: Culturing of samples obtained by sonication of prostheses was more sensitive than conventional periprosthetic-tissue culture for the microbiologic diagnosis of prosthetic hip and knee infection, especially in patients who had received antimicrobial therapy within 14 days before surgery.
Journal ArticleDOI
Synovial fluid leukocyte count and differential for the diagnosis of prosthetic knee infection.
Andrej Trampuz,Arlen D. Hanssen,Douglas R. Osmon,Jayawant N. Mandrekar,James M. Steckelberg,Robin Patel +5 more
TL;DR: In this article, the cutoff values for synovial fluid leukocyte count and neutrophil percentage for differentiating aseptic failure and prosthetic joint infection were defined.
Journal ArticleDOI
Perioperative Testing for Joint Infection in Patients Undergoing Revision Total Hip Arthroplasty
TL;DR: A synovial fluid cell count of >3000 white blood cells/mL was the most predictive perioperative testing modality in this study for determining the presence of periprosthetic infection when combined with an elevated preoperative erythrocyte sedimentation rate and C-reactive protein level in patients undergoing revision total hip arthroplasty.
Journal ArticleDOI
Inflammatory blood laboratory levels as markers of prosthetic joint infection: a systematic review and meta-analysis.
Elie F. Berbari,Tad M. Mabry,Geoffrey Tsaras,Mark J. Spangehl,Pat J. Erwin,Mohammad Hassan Murad,James M. Steckelberg,Douglas R. Osmon +7 more
TL;DR: A review of the evidence on the accuracy of the peripheral white blood-cell count, the erythrocyte sedimentation rate, serum C-reactive protein level, and serum interleukin-6 level for the diagnosis of prosthetic joint infection was presented in this article.
Journal ArticleDOI
Cell Count and Differential of Aspirated Fluid in the Diagnosis of Infection at the Site of Total Knee Arthroplasty
Elie Ghanem,Javad Parvizi,R. Stephen J. Burnett,Peter F. Sharkey,Nahid R. Keshavarzi,Ajay Aggarwal,Robert L. Barrack +6 more
TL;DR: The synovial fluid leukocyte count and differential are useful adjuncts to the erythrocyte sedimentation rate and the C-reactive protein level in the preoperative workup of infection at the site of a total knee arthroplasty.