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Periprosthetic joint infection (PJI) can be difficult to diagnose. The new European Bone and Joint Infection Society (EBJIS) definition has some advantages in clinical practice. It recognizes more clinically significant infections and precisely establishes those with the highest risk of management failure. The combination of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), synovial white blood cell (WBC) count, polymorphonuclear leukocyte percentage (PMN%), and platelet to volume ratio (PVR) has a sensitivity of 97.73% and a specificity of 100%. Drain fluid cultures can rule in but cannot rule out infection persistence in PJI. Next-generation sequencing (NGS) has higher sensitivity and diagnostic accuracy but slightly lower specificity than culture for the diagnosis of PJI.

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Diagnosis of Periprosthetic Joint Infection

  • 章节

  • 发表日期：

    2025年

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  • E. Carlos Rodríguez-Merchán,
  • Hortensia De la Corte-Rodríguez,
  • Juan M. Román-Belmonte

摘要

Periprosthetic joint infection (PJI) can be difficult to diagnose. The new European Bone and Joint Infection Society (EBJIS) definition has some advantages in clinical practice. It recognizes more clinically significant infections and precisely establishes those with the highest risk of management failure. The combination of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), synovial white blood cell (WBC) count, polymorphonuclear leukocyte percentage (PMN%), and platelet to volume ratio (PVR) has a sensitivity of 97.73% and a specificity of 100%. Drain fluid cultures can rule in but cannot rule out infection persistence in PJI. Next-generation sequencing (NGS) has higher sensitivity and diagnostic accuracy but slightly lower specificity than culture for the diagnosis of PJI.