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Laboratory diagnosis of Prosthetic Joint Infections: Current concepts and present status

Raju Vaishya1, Raman Sardana2, Hena Butta2

  • 1Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, SaritaVihar, New Delhi, 110076, India.

Journal of Clinical Orthopaedics and Trauma
|May 8, 2019
PubMed

Insights

Diagnosing prosthetic joint infection (PJI) is complex. Alpha defensins show promise as a synovial fluid biomarker, aiding in the accurate diagnosis of PJI in patients undergoing joint replacement surgery.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Prosthetic joint infection (PJI) presents diagnostic and management challenges for orthopedic surgeons and microbiologists.
  • Current diagnostic criteria for PJI have limitations and inconsistencies.
  • Accurate diagnosis is crucial for effective treatment and patient outcomes.

Purpose of the Study:

  • To review current laboratory investigations for diagnosing PJI.
  • To evaluate the utility of novel biomarkers, specifically alpha defensins, in PJI diagnosis.
  • To present emerging diagnostic methods, including molecular techniques and enhanced culture methods.

Main Methods:

  • Review of existing literature on diagnostic methods for PJI.
  • Analysis of the performance characteristics of various laboratory tests.
  • Discussion of the role of synovial fluid biomarkers, with a focus on alpha defensins.
  • Exploration of advanced techniques like molecular assays and modified cultures.

Main Results:

  • Traditional diagnostic methods for PJI have inherent fallacies.
  • Alpha defensins in synovial fluid demonstrate potential as a reliable biomarker for PJI.
  • Newer molecular and culture-based techniques offer improved diagnostic accuracy for PJI.

Conclusions:

  • Alpha defensins represent a valuable addition to the diagnostic arsenal for PJI.
  • A combination of established and novel methods may be required for optimal PJI diagnosis.
  • Continued research into advanced diagnostic tools is essential for improving PJI management.
Keywords:
ArthroplastyJoint replacementLaboratory diagnosisMicrobesProsthetic joint infection

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