Youssef Yasmin, Hättich Annika, Klepka Kim Lydia
Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Leipzig, Germany.
Department of Trauma and Orthopaedic Surgery, University Hospital Hamburg Eppendorf, Hamburg, Germany.
Innov Surg Sci. 2024 Nov 20;9(4):191-197. doi: 10.1515/iss-2024-0016. eCollection 2024 Dec.
Periprosthetic joint infections (PJIs) are dramatic complications after primary total joint arthroplasty. Despite increasing research in this field, the diagnosis, classification, and management of PJI remain a challenge. This is mainly due to the heterogenous clinical presentation of PJI in clinical routine and patient-related factors as secondary diagnosis and periprosthetic tissue condition. The early detection of PJI is essential for adequate treatment. However, there is no definition for PJI with 100 % sensitivity or a negative predictive value. This can potentially lead to a delayed or missed diagnosis of PJI. Furthermore, the surgical and antibiotic treatment is among the most discussed topics in PJI literature. There is no international consensus on the treatment of different PJI entities. Concludingly many aspects of PJI diagnostics and treatment remain controversially discussed and current studies are only comparable to a limited extent due to study heterogeneity and limited comparability.
人工关节周围感染(PJI)是初次全关节置换术后的严重并发症。尽管该领域的研究不断增加,但PJI的诊断、分类和管理仍然是一项挑战。这主要是由于临床常规中PJI的临床表现各异以及患者相关因素,如二次诊断和人工关节周围组织状况。PJI的早期检测对于充分治疗至关重要。然而,尚无具有100%敏感性或阴性预测值的PJI定义。这可能导致PJI的诊断延迟或漏诊。此外,手术和抗生素治疗是PJI文献中讨论最多的话题之一。对于不同PJI实体的治疗,目前尚无国际共识。总之,PJI诊断和治疗的许多方面仍存在争议,由于研究的异质性和可比性有限,目前的研究仅在有限程度上具有可比性。