Related Experiment Video
Updated: Sep 12, 2025
10:35
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
11.2K
Novel Technologies in Periprosthetic Joint Infection: Emerging Diagnostics
Matthew L Magruder1, Nathanael D Heckmann2, Jay R Lieberman2
1Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York.
The Journal of Arthroplasty
|August 9, 2025
Summary
Novel diagnostic tools like pH sensors and calprotectin assays offer faster, more accurate detection of periprosthetic joint infection (PJI) after total joint arthroplasty (TJA). These methods improve patient outcomes by enabling earlier PJI diagnosis and treatment.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Biomarker Discovery
- Diagnostic Technologies
Background:
- Periprosthetic joint infection (PJI) is a significant complication of total joint arthroplasty (TJA), leading to high morbidity and implant failure.
- Current diagnostic methods for PJI, such as synovial fluid analysis and cultures, have limitations in sensitivity and specificity, especially for culture-negative cases.
- There is a critical need for advanced diagnostic technologies for rapid and reliable PJI detection.
Purpose of the Study:
- To review and explore emerging diagnostic strategies for periprosthetic joint infection (PJI).
- To highlight novel technologies that offer improved accuracy and speed in PJI diagnosis.
- To discuss the potential impact of these innovations on patient outcomes and prosthetic longevity.
Main Methods:
- Review of emerging diagnostic strategies including real-time intra-articular pH monitoring (e.g., X-ray-based sensors, XELCI).
- Evaluation of urinary peptide biomarkers for systemic inflammatory response detection.
- Assessment of multiomics techniques (transcriptomics, proteomics, immune cell profiling) and advanced synovial fluid assays, focusing on calprotectin.
Main Results:
- Implantable pH sensors and XELCI enable noninvasive, early detection of synovial environment changes indicative of infection.
- Urinary peptide biomarkers offer a noninvasive method to reflect systemic inflammation associated with PJI.
- Synovial calprotectin, detected via lateral flow assay, shows high sensitivity and specificity for differentiating PJI from aseptic failures, serving as a point-of-care tool.
Conclusions:
- Emerging diagnostic technologies, including pH monitoring, urinary biomarkers, multiomics, and synovial calprotectin assays, show promise for revolutionizing PJI detection.
- These novel methods have the potential to reduce diagnostic delays and the need for invasive procedures.
- Further large-scale clinical validation is necessary to establish these innovations as standard-of-care for improved patient outcomes and prosthetic joint survival.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
40
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
40
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
36
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
36
01:18Endocarditis III: Medical Management
17
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
17
01:25Endocarditis I: Introduction
26
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
26
01:19MALDI-TOF Mass Spectrometry
5.2K
Mass spectrometry is a powerful characterization technique that can identify and separate a wide variety of compounds ranging from chemical to biological entities, based on their mass-to-charge ratio (m/z). The instruments that allow this detection, known as mass spectrometers, have three components: an ion source, a mass analyzer, and a detector. These spectrometers differ based on the nature of their ion source and analyzers.
Matrix-assisted laser desorption ionization (MALDI) is a commonly...
Matrix-assisted laser desorption ionization (MALDI) is a commonly...
5.2K
01:30Bacterial Signaling
34.2K
Bacterial signaling can occur within bacteria (intracellular) or between bacteria (intercellular). At times, a group of bacteria behaves like a community. To achieve this, they engage in quorum sensing, the perception of higher cell density that causes changes in gene expression. Quorum sensing involves both extracellular and intracellular signaling. The signaling cascade starts with a molecule called an autoinducer (AI). Individual bacteria produce AIs that move out of the bacterial cell...
34.2K