Prosthetic joint infection

Abstract

There is no uniformly accepted definition for prosthetic joint infection. The presentation is often varied, and the classical features of infection, such as fever, leukocytosis, and other typical signs of sepsis, are often absent. A prosthesis is a foreign body, and its presence alone is a risk factor for infection. Also, the microorganism load that will produce an established infection in a prosthetic joint is often less compared to a native joint.The strongest factor that defines prosthetic joint infection is perhaps the recovery of a microorganism from a joint aspirate or surgically obtained peri-prosthetic material. Other factors that support prosthetic joint infection include the presence of a sinus tract communicating with the joint space, wound dehiscence, purulence around the joint without an alternative explanation, loosening of the prosthesis, elevated synovial fluid leukocyte count with neutrophil predominance, and elevated inflammatory markers. However, failure to identify a pathogen does not rule out infection.