a:1:{s:5:"en_US";s:24:"Santorso, Alto Vicentino";}.
Department of Orthopedics and Traumatology, Azienda Ospedaliera Universitaria Integrata di Verona.
Acta Biomed. 2023 Jun 23;94(S2):e2023095. doi: 10.23750/abm.v94iS2.13792.
Periprosthetic joint infection (PJI) is a serious complication following hip arthroplasty, which is associated with significant health cost, morbidity and mortality. There is currently no consensus in the optimal definition of PJI, and establishing diagnosis is challenging because of conflicting guidelines, numerous tests, and limited evidence, with no single test providing a sensitivity and specificity of 100%. Consequently, the diagnosis of PJI is based on a combination of clinical data, laboratory results from peripheral blood and synovial fluid, microbiological culture, histological evaluation of periprosthetic tissue, radiological investigations, and intraoperative findings. Usually, a sinus tract communicating with the prosthesis and two positive cultures for the same pathogen were regarded as major criteria for the diagnosis, but, in recent years, the availability of new serum and synovial biomarkers as well as molecular methods have shown encouraging results. Culture-negative PJI occurs in 5-12% of cases and is caused by low-grade infection as well as by previous or concomitant antibiotic therapy. Unfortunately, delay in diagnosis of PJI is associated with poorer outcomes. In this article, the current knowledge in epidemiology, pathogenesis, classification, and diagnosis of prosthetic hip infections is reviewed.
人工关节周围感染（PJI）是髋关节置换术后的一种严重并发症，与巨大的健康成本、发病率和死亡率相关。目前，对于 PJI 的最佳定义尚未达成共识，由于指南存在冲突、检测方法众多、证据有限，且没有任何单一检测方法的灵敏度和特异性达到 100%，因此，PJI 的诊断具有挑战性。其基于临床数据、外周血和滑液的实验室结果、微生物培养、假体周围组织的组织学评估、影像学研究和术中发现的综合判断。通常，与假体相通的窦道和同一病原体的两次阳性培养被认为是诊断的主要标准，但近年来，新的血清和滑液生物标志物以及分子方法的出现取得了令人鼓舞的结果。5-12%的病例存在培养阴性的 PJI，由低水平感染以及先前或同时的抗生素治疗引起。不幸的是，PJI 的诊断延迟与较差的预后相关。本文回顾了假体髋关节感染的流行病学、发病机制、分类和诊断的现有知识。
