Related Experiment Video
Updated: May 31, 2026

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Multimodal diagnosis of periprosthetic joint infection after total ankle arthroplasty
Kathrin Pfahl1, Julia Eder2, Veit Krenn3
1Schön Klinik München Harlaching - FIFA Medical Centre, Munich 81547, Germany; Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany.
Background:
Diagnosing periprosthetic joint infection (PJI) after total ankle arthroplasty (TAA) remains challenging. This study evaluated clinical, laboratory, imaging, microbiological and histopathological parameters in suspected PJI after TAA. We hypothesized that a multimodal approach improves diagnosis.
Methods:
This retrospective study included 57 patients with suspected PJI after TAA and applied European Bone and Joint Infection Society (EBJIS) criteria. Pre- and intraoperative parameters were analyzed using correlation, group comparison and L1-regularized logistic regression.
Results:
33 patients were classified as infection unlikely, 5 as likely, and 19 as confirmed. Strong associations with PJI were observed for 99mTc-SPECT/CT (rs = 0.88), synovial neutrophil percentage, blood culture positivity, microbiology, histology, and sonication (all p < .001).
Conclusions:
Clinical signs, synovial fluid analysis, microbiology, histology, sonication, and 99mTc-SPECT/CT showed substantial discriminatory value and support a multimodal diagnostic strategy in suspected ankle PJI.
Levels Of Evidence:
Level IV.
Related Concept Videos
Ankle Joint
Peripheral Artery Disease V: Postoperative Nursing Management
Acute Pyelonephritis II: Diagnostic Studies and Management
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
