Periprosthetic joint infection (PJI) is a serious complication after joint arthroplasty. Diagnosing PJI can be challenging as preoperative screening and conventional cultures may be inconclusive. Sonication fluid culturing stands out as a valuable adjunct technique to improve microbiological PJI diagnosis. This study aims to determine the clinical relevance of routinely using sonication for all septic and aseptic revisions. All patients who underwent (partial) hip or knee revision arthroplasty for all causes between 2012 and 2021 at our institution were retrospectively reviewed. Based on the European Bone and Joint Society PJI criteria, we categorized them into three groups: infection confirmed, infection likely, and infection unlikely. We analyzed the clinical, laboratory, and radiological screening that could confirm or refute suspicion of PJI. We analyzed microbiology cultures and the most frequently detected microorganisms. Sensitivity and specificity were calculated for synovial fluid cultures (preoperative), tissue cultures, and sonication fluid cultures. We determined the clinical relevance of sonication as the percentage of patients for whom sonication confirmed (microbiological) PJI diagnosis.Aim
Method
Late acute prosthetic joint infections (PJI) treated with surgical debridement and implant retention (DAIR) have a high failure rate. The aim of our study was to evaluate treatment outcome in late acute PJIs treated with DAIR versus implant removal. In a large multicenter study, late acute PJIs were retrospectively evaluated. Failure was defined as: PJI related death or the need for prosthesis removal or suppressive antibiotic therapy because of persistent or recurrent signs of infection. Late acute PJI was defined as < 3 weeks of symptoms more than 3 months after the index surgery.Aim
Method
Debridement, antibiotics and implant retention (DAIR) is the recommended treatment for all acute prosthetic joint infections (PJI). However, the efficacy of DAIR and identification of risk factors for failure in patients with late acute PJI, is not well described. Patients diagnosed with late acute PJI between 2005 and 2015 were retrospectively evaluated. Late acute PJI was defined as the development of acute symptoms (≤ 3 weeks) occurring ≥ 3 months after arthroplasty. Failure was defined as: i) the need for implant removal, ii) infection related death, iii) the need for suppressive antibiotic therapy due to persistent signs of infection and/or iv) relapse or reinfection during follow-up.Aim
Method
