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The EBJIS definition of periprosthetic joint infection

Martin McNally1, Ricardo Sousa2, Marjan Wouthuyzen-Bakker3

  • 1The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK.

The Bone & Joint Journal
|December 31, 2020
PubMed
Abstract

Insights

Diagnosing periprosthetic joint infection (PJI) is challenging. This study introduces a new, evidence-based, three-level diagnostic approach for PJI, offering improved clinical guidance.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Diagnostic Medicine

Background:

  • Periprosthetic joint infection (PJI) diagnosis is complex, with current methods lacking accuracy and consistent interpretation.
  • Existing diagnostic criteria for PJI are not universally accepted, and a definitive reference standard is absent.
  • Numerous novel diagnostic tests for PJI exist, but their roles in the diagnostic pathway remain undefined.

Purpose of the Study:

  • To develop a universally accepted definition and diagnostic guidance for periprosthetic joint infection (PJI).
  • To establish a consensus on the diagnostic pathway for PJI based on robust evidence.
  • To provide clinicians with a practical, three-level approach for diagnosing PJI.

Main Methods:

  • A comprehensive literature review was conducted.
  • Discussions were held with members of the European Bone and Joint Infection Society (EBJIS), Musculoskeletal Infection Society (MSIS), and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Implant-Associated Infections (ESGIAI).
  • An expert panel assessed the literature and discussion outcomes to formulate diagnostic guidance.

Main Results:

  • A novel three-level approach to the diagnostic continuum for PJI was developed.
  • A consensus definition set and clinical guidance for PJI diagnosis were established.
  • The developed guidance received full endorsement from EBJIS, MSIS, and ESGIAI.

Conclusions:

  • The new definition offers a practical, three-level diagnostic strategy for PJI.
  • This evidence-based approach is designed to assist clinicians in the daily diagnosis of PJI.
  • The guidance aims to standardize and improve the accuracy of PJI diagnosis in clinical practice.
Keywords:
ArthroplastyDefinitionDiagnosisEBJISInfectionProsthetic joint infection

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