Related Experiment Video
Updated: Aug 18, 2026

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
A protocol for periprosthetic joint infections from the Northern Infection Network for Joint Arthroplasty (NINJA) in
W P Zijlstra1, J J W Ploegmakers2, G A Kampinga3
1Department of Orthopedic Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
Abstract:
Periprosthetic joint infection (PJI) is a devastating complication of joint arthroplasty surgery. Treatment success depends on accurate diagnostics, adequate surgical experience and interdisciplinary consultation between orthopedic surgeons, plastic surgeons, infectious disease specialists and medical microbiologists. For this purpose, we initiated the Northern Infection Network for Joint Arthroplasty (NINJA) in the Netherlands in 2014. The establishment of a mutual diagnostic and treatment protocol for PJI in our region has enabled mutual understanding, has supported agreement on how to treat specific patients, and has led to clarity for smaller hospitals in our region for when to refer patients without jeopardizing important initial treatment locally. Furthermore, a mutual PJI patient database has enabled the improvement of our protocol, based on medicine-based evidence from our scientific data. In this paper we describe our NINJA protocol.Level of evidence: III.
Related Concept Videos
Healthcare 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...
Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
Endocarditis IV: Nursing Management
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
Acute Pyelonephritis I: Introduction
Acute Pyelonephritis II: Diagnostic Studies and Management

