Review
Biochemistry & Molecular Biology
Corneliu Ovidiu Vrancianu, Bogdan Serban, Irina Gheorghe-Barbu, Ilda Czobor Barbu, Roxana Elena Cristian, Mariana Carmen Chifiriuc, Catalin Cirstoiu
Summary: The number of implanted prosthetic joints is increasing due to longer life spans and increased mobility in older individuals. Unfortunately, the number of periprosthetic joint infections (PJIs), a severe complication after joint replacement surgery, is also on the rise. Efficient protocols for managing these infections can lead to preventive measures and effective diagnostic methods using laboratory tests. This review discusses current methods for PJI diagnosis and emerging synovial biomarkers used for prognosis, prophylaxis, and early detection of periprosthetic infections, as well as factors contributing to treatment failure.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Orthopedics
Graham S. Goh, Javad Parvizi
Summary: Identifying the causative organisms in periprosthetic joint infection (PJI) is a challenging task, with traditional culture methods being criticized for their limitations, resulting in a clinical entity known as "culture-negative PJI." As biofilm infections become more prevalent and difficult to culture, the field of clinical microbiology has shifted from culture-based to molecular-based methods. These novel techniques show promise in addressing culture-negative PJI and revolutionizing the microbiology laboratory.
JOURNAL OF ARTHROPLASTY
(2022)
Editorial Material
Orthopedics
V. Rajput, R. M. D. Meek, F. S. Haddad
Summary: Periprosthetic joint infection is a challenging complication with many unanswered questions. Despite progress in defining and treating the infection, further research is needed to identify the organisms involved and resolve remaining problems.
BONE & JOINT JOURNAL
(2022)
Review
Orthopedics
Ashraf T. Hantouly, Osama Alzobi, Ahmad A. Toubasi, Bashir Zikria, Mohammed Al Ateeq Al Dosari, Ghalib Ahmed
Summary: This meta-analysis compared the diagnostic parameters of synovial next-generation sequencing (NGS) and cultures in diagnosing periprosthetic joint infections (PJI). The results showed that NGS has potential in diagnosing hip and knee PJIs due to its high sensitivity, specificity, and accuracy. However, the sensitivity and specificity reported by the studies varied according to the time of synovial sampling.
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
(2023)
Article
Microbiology
Changyu Huang, Ying Huang, Ziwen Wang, Yiming Lin, Yongbin Li, Yang Chen, Xiaoqing Chen, Chaofan Zhang, Wenbo Li, Wenming Zhang, Xinyu Fang, Zida Huang
Summary: In this study, multiple PCR-based targeted next-generation sequencing (tNGS) was used to detect pathogens in periprosthetic joint infection (PJI), and the results were compared with culture and metagenomic NGS (mNGS). The study found that tNGS had similar sensitivity and specificity to culture and mNGS for PJI diagnosis, and it was able to detect drug resistance genes. Furthermore, tNGS had advantages in cost and turnaround time compared to mNGS. Overall, tNGS has important clinical value in the diagnosis of PJI.
FRONTIERS IN MICROBIOLOGY
(2023)
Review
Immunology
Sandra B. Nelson, Jodian A. Pinkney, Antonia F. Chen, Aaron J. Tande
Summary: This review provides an overview of current care for periprosthetic joint infection, highlighting the need for interdisciplinary collaboration and addressing diagnostic and management challenges. Periprosthetic joint infection has become more prevalent and complex over time, and although advances have been made in surgical and medical treatments, there are still gaps in understanding. The article presents current approaches to diagnosing and managing periprosthetic joint infection, with a focus on common clinical challenges and collaborative interdisciplinary care.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Health Care Sciences & Services
Yi Ren, Lara Biedermann, Clemens Gwinner, Carsten Perka, Arne Kienzle
Summary: Current diagnostic standards for periprosthetic joint infection in rheumatoid arthritis patients are challenging due to overlaps with autoimmune markers. Routine laboratory markers have limited utility in distinguishing between chronic PJI and rheumatoid arthritis, emphasizing the importance of further research in this area.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Multidisciplinary Sciences
Igor Lazic, Susanne Feihl, Peter M. Prodinger, Ingo J. Banke, Andrej Trampuz, Rudiger von Eisenhart-Rothe, Christian Suren
Summary: Multiplex PCR for identification of pathogens in tissue biopsies of patients with periprosthetic joint infection showed low diagnostic accuracy compared to routine microbiological cultures, with potential for false negative results; however, it offers rapid pathogen identification, suggesting further exploration with careful specimen selection.
SCIENTIFIC REPORTS
(2021)
Article
Multidisciplinary Sciences
Linjie Hao, Pengfei Wen, Wei Song, Binfei Zhang, Yanjie Wu, Yumin Zhang, Tao Ma, Yusheng Qiu
Summary: This study evaluated the use of metagenomic next-generation sequencing for pathogen detection in periprosthetic joint infections. Samples from 95 patients who had undergone revision surgery for hip and knee replacement were analyzed. Culture and metagenomic next-generation sequencing were used to detect pathogens, and the sensitivity, specificity, and predictive values were compared. The results showed that metagenomic next-generation sequencing had a higher detection rate than culture, especially in cases with multiple infections or negative culture results.
SCIENTIFIC REPORTS
(2023)
Article
Infectious Diseases
Laure Flurin, Matthew J. Wolf, Kerryl E. Greenwood-Quaintance, Joaquin Sanchez-Sotelo, Robin Patel
Summary: 16S rRNA gene-based targeted metagenomic analysis of sonicate fluid showed higher sensitivity compared to culture in diagnosing periprosthetic joint infections.
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE
(2021)
Article
Microbiology
Kyle H. Cichos, Randall J. Ruark, Elie S. Ghanem
Summary: Isothermal microcalorimetry (IMC) is a clinically effective method for diagnosing periprosthetic joint infection (PJI) in hip/knee replacements, with improved diagnostic accuracy and shorter detection time compared to conventional cultures. It shows higher sensitivity, specificity, and accuracy, especially in patients on chronic antibiotics.
JOURNAL OF CLINICAL MICROBIOLOGY
(2023)
Review
Immunology
Sandra B. Nelson, Jodian A. Pinkney, Antonia F. Chen, Aaron J. Tande
Summary: This review presents the current approaches to the diagnosis and management of periprosthetic joint infection, with a focus on multidisciplinary collaboration, common diagnostic and management challenges, and patient-centered decision making.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Orthopedics
Pier F. Indelli, Stefano Ghirardelli, Bruno Violante, Derek F. Amanatullah
Summary: Next generation sequencing (NGS) is a promising tool for rapid diagnosis of periprosthetic joint infections (PJI), offering the potential to detect pathogens and antimicrobial resistance genes quickly. While revolutionary, NGS technologies still require further clinical evidence before becoming widely adopted for PJI diagnosis.
EFORT OPEN REVIEWS
(2021)
Article
Immunology
Yuanqing Cai, Haiqi Ding, Xiaoqing Chen, Yang Chen, Changyu Huang, Chaofan Zhang, Zida Huang, Ying Huang, Wenbo Li, Wenming Zhang, Xinyu Fang
Summary: In this study, a metagenomic next-generation sequencing (mNGS)-based diagnostic strategy was reported for the diagnosis of Mycoplasma periprosthetic joint infection (PJI). The largest number of Mycoplasma PJI cases were accurately diagnosed by mNGS and verified by optimized microbial culture methods and (or) 16S PCR. The positive rates of optimized microbial culture methods and 16S PCR were 57.14% and 71.43% respectively, and targeted treatment effectively controlled the infections in all cases. This standardized and optimized procedure based on mNGS provides a useful diagnostic strategy for Mycoplasma PJI and may also be applicable to rare bacterial PJI.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2023)
Article
Orthopedics
Yanyang Chen, Huhu Wang, Xiyao Chen, Hairong Ma, Jingjie Zheng, Li Cao
Summary: Serum D-lactate, fibrinogen (FIB) and ESR showed similar performance for the diagnosis of PJI. Serum D-lactate had the highest sensitivity and specific advantages, making it a useful point-of-care screening test for PJI.
BMC MUSCULOSKELETAL DISORDERS
(2022)