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Advances in the diagnosis of periprosthetic joint infection
H John Cooper1, Craig J Della Valle
1Lenox Hill Hospital, Department of Orthopaedic Surgery, 130 East 77th Street, 11th Floor, New York, NY 10075, USA. jcooper02@gmail.com
Introduction:
Identification of periprosthetic joint infection (PJI) is critical, as the treatment between infected and non-infected arthroplasties is fundamentally different and missing the diagnosis may lead to a delay in diagnosis and the potential for a decreased rate of treatment success. Yet in the absence of a true gold standard, the diagnosis of PJI can be elusive. Given the rising incidence of this PJI and the growing infection burden anticipated in coming years, much effort is being put toward improving diagnostic tests for PJI.
Areas Covered:
The best current practice for diagnosis of PJI is to follow an algorithmic approach. Emerging technology such as advanced imaging modalities, increasing availability of serum markers, synovial fluid biomarker analysis and new point-of-care modalities offer the potential to greatly enhance our ability to identify PJI in the future.
Expert Opinion:
As there has been more focus on the diagnosis of PJI in recent years, new tests have been developed. These new tests will need to be rigorously evaluated before being incorporated into the diagnostic algorithm. Synovial fluid biomarker analysis and greater access to point-of-care testing may allow the biggest improvements in the diagnosis of PJI in the near future.
Insights
Accurate diagnosis of periprosthetic joint infection (PJI) is vital for successful treatment. New diagnostic tests, including synovial fluid biomarkers and point-of-care options, show promise for improving PJI identification.
Area of Science:
- Orthopedic surgery
- Infectious disease diagnostics
- Biomarker research
Background:
- Periprosthetic joint infection (PJI) diagnosis is critical due to differing treatments for infected vs. non-infected arthroplasties.
- Delayed PJI diagnosis can reduce treatment success rates.
- Rising PJI incidence necessitates improved diagnostic methods.
Purpose of the Study:
- To review current and emerging diagnostic approaches for periprosthetic joint infection (PJI).
- To highlight advancements in PJI diagnostic technologies.
- To discuss the future of PJI diagnosis.
Main Methods:
- Review of current best practices for PJI diagnosis using an algorithmic approach.
- Evaluation of emerging diagnostic technologies, including advanced imaging, serum markers, synovial fluid biomarkers, and point-of-care modalities.
- Analysis of recent developments in PJI diagnostic tests.
Main Results:
- Current PJI diagnosis relies on an algorithmic approach.
- Emerging technologies offer significant potential to enhance PJI detection.
- New diagnostic tests for PJI have been developed.
Conclusions:
- Rigorous evaluation of new PJI diagnostic tests is essential before clinical adoption.
- Synovial fluid biomarker analysis and point-of-care testing are anticipated to significantly improve PJI diagnosis in the near future.
- Continued research and development are crucial for advancing PJI diagnostic capabilities.
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