Cargando…

Periprosthetic Joint Infection Diagnosis: A Narrative Review

Replacement of native joints aims to restore patients’ quality of life by relieving pain and improving joint function. While periprosthetic joint infection (PJI) affects a small percentage of patients, with an estimated incidence of 1–9% following primary total joint replacement, this postoperative...

Descripción completa

Detalles Bibliográficos
Autores principales: Tsikopoulos, Konstantinos, Meroni, Gabriele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604393/
https://www.ncbi.nlm.nih.gov/pubmed/37887186
http://dx.doi.org/10.3390/antibiotics12101485
_version_ 1785126824804614144
author Tsikopoulos, Konstantinos
Meroni, Gabriele
author_facet Tsikopoulos, Konstantinos
Meroni, Gabriele
author_sort Tsikopoulos, Konstantinos
collection PubMed
description Replacement of native joints aims to restore patients’ quality of life by relieving pain and improving joint function. While periprosthetic joint infection (PJI) affects a small percentage of patients, with an estimated incidence of 1–9% following primary total joint replacement, this postoperative complication necessitates a lengthy hospitalisation, extended antibiotic treatment and further surgery. It is highlighted that establishing the correct diagnosis of periprosthetic infections is critical in order for clinicians to avoid unnecessary treatments in patients with aseptic failure. Of note, the PJI diagnosis could not purely rely upon clinical manifestations given the fact that heterogeneity in host factors (e.g., age and comorbidities), variability in infection period, difference in anatomical location of the involved joint and discrepancies in pathogenicity/virulence of the causative organisms may confound the clinical picture. Furthermore, intra-operative contamination is considered to be the main culprit that can result in early or delayed infection, with the hematogenous spread being the most prevalent mode. To elaborate, early and hematogenous infections often start suddenly, whereas chronic late infections are induced by less virulent bacteria and tend to manifest in a more quiescent manner. Last but not least, viruses and fungal microorganisms exert a role in PJI pathogenesis.
format Online
Article
Text
id pubmed-10604393
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-106043932023-10-28 Periprosthetic Joint Infection Diagnosis: A Narrative Review Tsikopoulos, Konstantinos Meroni, Gabriele Antibiotics (Basel) Review Replacement of native joints aims to restore patients’ quality of life by relieving pain and improving joint function. While periprosthetic joint infection (PJI) affects a small percentage of patients, with an estimated incidence of 1–9% following primary total joint replacement, this postoperative complication necessitates a lengthy hospitalisation, extended antibiotic treatment and further surgery. It is highlighted that establishing the correct diagnosis of periprosthetic infections is critical in order for clinicians to avoid unnecessary treatments in patients with aseptic failure. Of note, the PJI diagnosis could not purely rely upon clinical manifestations given the fact that heterogeneity in host factors (e.g., age and comorbidities), variability in infection period, difference in anatomical location of the involved joint and discrepancies in pathogenicity/virulence of the causative organisms may confound the clinical picture. Furthermore, intra-operative contamination is considered to be the main culprit that can result in early or delayed infection, with the hematogenous spread being the most prevalent mode. To elaborate, early and hematogenous infections often start suddenly, whereas chronic late infections are induced by less virulent bacteria and tend to manifest in a more quiescent manner. Last but not least, viruses and fungal microorganisms exert a role in PJI pathogenesis. MDPI 2023-09-27 /pmc/articles/PMC10604393/ /pubmed/37887186 http://dx.doi.org/10.3390/antibiotics12101485 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Tsikopoulos, Konstantinos
Meroni, Gabriele
Periprosthetic Joint Infection Diagnosis: A Narrative Review
title Periprosthetic Joint Infection Diagnosis: A Narrative Review
title_full Periprosthetic Joint Infection Diagnosis: A Narrative Review
title_fullStr Periprosthetic Joint Infection Diagnosis: A Narrative Review
title_full_unstemmed Periprosthetic Joint Infection Diagnosis: A Narrative Review
title_short Periprosthetic Joint Infection Diagnosis: A Narrative Review
title_sort periprosthetic joint infection diagnosis: a narrative review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604393/
https://www.ncbi.nlm.nih.gov/pubmed/37887186
http://dx.doi.org/10.3390/antibiotics12101485
work_keys_str_mv AT tsikopouloskonstantinos periprostheticjointinfectiondiagnosisanarrativereview
AT meronigabriele periprostheticjointinfectiondiagnosisanarrativereview