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Advancements in Diagnosing Periprosthetic Joint Infections after Total Hip and Knee Arthroplasty

Periprosthetic joint infection (PJI) is a complication of total joint arthroplasty that is challenging to diagnose. Currently, there is no “gold standard” for definite diagnosis of PJI. A multi-criteria definition has been described for PJI based on microbiology cultures, serum markers, such as eryt...

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Autores principales: Patel, Ripal, Alijanipour, Pouya, Parvizi, Javad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bentham Open 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220175/
https://www.ncbi.nlm.nih.gov/pubmed/28144375
http://dx.doi.org/10.2174/1874325001610010654
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author Patel, Ripal
Alijanipour, Pouya
Parvizi, Javad
author_facet Patel, Ripal
Alijanipour, Pouya
Parvizi, Javad
author_sort Patel, Ripal
collection PubMed
description Periprosthetic joint infection (PJI) is a complication of total joint arthroplasty that is challenging to diagnose. Currently, there is no “gold standard” for definite diagnosis of PJI. A multi-criteria definition has been described for PJI based on microbiology cultures, serum markers, such as erythrocyte sedimentation rate and C-reactive protein (CRP), synovial fluid biomarkers, such as leukocyte esterase and histopathology assessment of the periprosthetic tissue. The conventional serum markers are generally nonspecific and can be elevated in inflammatory conditions. Therefore, they cannot be relied on for definite diagnosis of PJI. Hence, with the use of proteomics, synovial fluid biomarkers such as α-defensin, IL-6, and CRP have been proposed as more accurate biomarkers for PJI. Current methods to culture micro-organisms have several limitations, and can be false-negative and false-positive in a considerable number of cases. In an attempt to improve culture sensitivity, diagnostic methods to target biofilms have recently been studied. The understanding of the concept of biofilms has also allowed for the development of novel techniques for PJI diagnosis, such as visualizing biofilms with fluorescent in-situ hybridization and detection of bacteria via DNA microarray. Lastly, the use of amplification-based molecular techniques has provided methods to identify specific species of bacteria that cause culture-negative PJI. While diagnosing PJI is difficult, these advances could be valuable tools for clinicians.
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spelling pubmed-52201752017-01-31 Advancements in Diagnosing Periprosthetic Joint Infections after Total Hip and Knee Arthroplasty Patel, Ripal Alijanipour, Pouya Parvizi, Javad Open Orthop J Article Periprosthetic joint infection (PJI) is a complication of total joint arthroplasty that is challenging to diagnose. Currently, there is no “gold standard” for definite diagnosis of PJI. A multi-criteria definition has been described for PJI based on microbiology cultures, serum markers, such as erythrocyte sedimentation rate and C-reactive protein (CRP), synovial fluid biomarkers, such as leukocyte esterase and histopathology assessment of the periprosthetic tissue. The conventional serum markers are generally nonspecific and can be elevated in inflammatory conditions. Therefore, they cannot be relied on for definite diagnosis of PJI. Hence, with the use of proteomics, synovial fluid biomarkers such as α-defensin, IL-6, and CRP have been proposed as more accurate biomarkers for PJI. Current methods to culture micro-organisms have several limitations, and can be false-negative and false-positive in a considerable number of cases. In an attempt to improve culture sensitivity, diagnostic methods to target biofilms have recently been studied. The understanding of the concept of biofilms has also allowed for the development of novel techniques for PJI diagnosis, such as visualizing biofilms with fluorescent in-situ hybridization and detection of bacteria via DNA microarray. Lastly, the use of amplification-based molecular techniques has provided methods to identify specific species of bacteria that cause culture-negative PJI. While diagnosing PJI is difficult, these advances could be valuable tools for clinicians. Bentham Open 2016-11-30 /pmc/articles/PMC5220175/ /pubmed/28144375 http://dx.doi.org/10.2174/1874325001610010654 Text en © Patel et al.; Licensee Bentham Open http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
spellingShingle Article
Patel, Ripal
Alijanipour, Pouya
Parvizi, Javad
Advancements in Diagnosing Periprosthetic Joint Infections after Total Hip and Knee Arthroplasty
title Advancements in Diagnosing Periprosthetic Joint Infections after Total Hip and Knee Arthroplasty
title_full Advancements in Diagnosing Periprosthetic Joint Infections after Total Hip and Knee Arthroplasty
title_fullStr Advancements in Diagnosing Periprosthetic Joint Infections after Total Hip and Knee Arthroplasty
title_full_unstemmed Advancements in Diagnosing Periprosthetic Joint Infections after Total Hip and Knee Arthroplasty
title_short Advancements in Diagnosing Periprosthetic Joint Infections after Total Hip and Knee Arthroplasty
title_sort advancements in diagnosing periprosthetic joint infections after total hip and knee arthroplasty
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220175/
https://www.ncbi.nlm.nih.gov/pubmed/28144375
http://dx.doi.org/10.2174/1874325001610010654
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