Diagnosis of Periprosthetic Joint Infection: Current Concepts

Prosthetic knee joint replacement improves the quality of life of thousands of patients with joint degeneration each year. Due to higher life expectancy, lifestyle changes and more expectations in elderly patients, the number of arthroplasties continues to rise. With a steadily increasing number of implantations, the number of periprosthetic joint infection (PJI) cases also rises continuously. Undoubtedly, PJI is one of the most frightening complications and it occurs in 1% to 2% of primary and in 4% of revision arthroplasties. PJI is defined as the infection of the prosthetic components and adjacent tissues and it is the main cause of failure of a knee prosthesis. Management of PJI requires an accurate diagnosis with identification of the infecting microorganism and a complex treatment strategy including multiple surgical revisions and long-term antimicrobial treatment. This is why the periprosthetic joint infection has been defined as the complication to "beat" in the 21st century. This multidisciplinary approach is crucial for achieving optimal outcomes. In the last decade we have witnessed an enormous advance in knowledge in various fundamental areas such as epidemiology, diagnosis, treatment and prevention of prosthetic knee infection. The aim of this open classroom is to update the diagnosis, including the various scientific advances developed in recent years.