Diagnosis of Periprosthetic Joint infection: from Novel Synovial Fluid Biomarkers to Identification of the Etiological Agent

Joint replacement surgery is a success story in orthopaedic surgery which brought clear clinical and economical benefits. As the prevalence of total joint arthroplasty continues to rise worldwide, the incidence of periprosthetic joint infection (PJI) is expected to increase [1]. Infection of the prosthesis is one of the most worrisome complications and has an overwhelming impact on patients and society. PJI is difficult to diagnose and treat as there remains no diagnostic ‘gold-standard’ method. A high index of suspicion is key due to the heterogeneous behaviour of the microorganisms involved and therefore the diverse clinical presentation [2]. Some of the patients submitted to an aseptic revision surgery might actually have PJI. Not every patient with a PJI meets the criteria of Musculoskeletal Infection Society (MSIS), which are the most used for diagnosing PJI and include 2 major and 5 minor criteria [3].