Optimized use and performance of culture for periprosthetic joint infection diagnosis: a comprehensive literature...

Area of Science:

• Orthopedic surgery
• Infectious diseases
• Medical microbiology

Background:

• Periprosthetic joint infection (PJI) is a serious complication following arthroplasty.
• Accurate diagnosis of PJI is essential for effective treatment.
• Current diagnostic methods, particularly culture-based techniques, have limitations.

Purpose of the Study:

• To clarify the optimal utilization of culture in the diagnostic approach to PJI.
• To inform the development of a unified definition of PJI.
• To establish best practices for synovial fluid and periprosthetic tissue culture.

Main Methods:

• A systematic review was conducted to evaluate the role of culture in PJI definition.
• A comprehensive review of synovial fluid and periprosthetic tissue collection, culture methodology, and interpretation was performed.
• Literature gaps were identified to guide future research.

Main Results:

• Culture is critical for confirming PJI diagnosis.
• Characterizing the infecting microorganism(s) via culture informs treatment strategies.
• Best practices for sample collection and analysis were reviewed.

Conclusions:

• Culture remains a cornerstone in the diagnosis and management of PJI.
• Standardized approaches to culture are needed for improved diagnostic accuracy.
• Further research is required to address identified literature gaps.