Related Experiment Video
Updated: Aug 9, 2026
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Prosthetic joint infections: update in diagnosis and treatment
Andrej Trampuz1, Werner Zimmerli
1Division of Infectious diseases and Hospital Epidemiology, University Hospital, Basel, Switzerland.
Abstract:
The pathogenesis of prosthetic joint infection is related to microorganisms growing in biofilms, rendering these infections difficult to diagnose and to eradicate. Low-grade infections in particular are difficult to distinguish from aseptic failure, often presenting only with early loosening and persisting pain, or no clinical signs of infection at all. A combination of preoperative and intraoperative tests is usually needed for an accurate diagnosis of infection of prosthetic joint infections. Successful treatment requires adequate surgical procedure combined with long-term antimicrobial therapy, ideally with an agent acting on adhering stationary- phase microorganisms. In this article, epidemiology, pathogenesis, diagnosis and treatment of prosthetic joint infections are reviewed.
Insights
Prosthetic joint infections are hard to diagnose and treat due to biofilms. Early detection and long-term antimicrobial therapy targeting stationary-phase bacteria are crucial for successful outcomes.
Area of Science:
- Orthopedics
- Infectious Diseases
- Microbiology
Background:
- Prosthetic joint infections (PJIs) are challenging due to microbial biofilms.
- Low-grade PJIs often mimic aseptic loosening, complicating diagnosis.
- Biofilms hinder effective eradication and diagnosis.
Purpose of the Study:
- To review the epidemiology, pathogenesis, diagnosis, and treatment of PJIs.
- To highlight the difficulties in diagnosing and treating PJIs.
- To emphasize the role of biofilms in PJI pathogenesis.
Main Methods:
- Review of current literature on prosthetic joint infections.
- Analysis of diagnostic challenges and treatment strategies.
- Focus on biofilm formation and antimicrobial resistance.
Main Results:
- Biofilm formation is central to PJI pathogenesis.
- Accurate diagnosis often requires a combination of preoperative and intraoperative tests.
- Effective treatment necessitates surgical intervention and prolonged antimicrobial therapy.
Conclusions:
- PJIs are difficult to diagnose and eradicate due to biofilms.
- Targeting stationary-phase microorganisms is key for successful antimicrobial therapy.
- Comprehensive diagnostic and therapeutic strategies are essential for managing PJIs.
Related Concept Videos
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:18Endocarditis III: Medical Management
01:29Endocarditis IV: Nursing Management
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:28Acute Pyelonephritis II: Diagnostic Studies and Management