title: Periprosthetic joint infection.
abstract: Periprosthetic joint infections are a devastating complication after arthroplasty and are associated with substantial patient morbidity. More than 25% of revisions are attributed to these infections, which are expected to increase. The increased prevalence of obesity, diabetes, and other comorbidities are some of the reasons for this increase. Recognition of the challenge of surgical site infections in general, and periprosthetic joint infections particularly, has prompted implementation of enhanced prevention measures preoperatively (glycaemic control, skin decontamination, decolonisation, etc), intraoperatively (ultraclean operative environment, blood conservation, etc), and postoperatively (refined anticoagulation, improved wound dressings, etc). Additionally, indications for surgical management have been refined. In this Review, we assess risk factors, preventive measures, diagnoses, clinical features, and treatment options for prosthetic joint infection. An international consensus meeting about such infections identified the best practices and further research needs. Orthopaedics could benefit from enhanced preventive, diagnostic, and treatment methods.
authors.affiliation: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, USA.
authors.forename: Bhaveen H
authors.initials: BH
authors.lastname: Kapadia
authors.affiliation: Department of Infectious Disease, Sinai Hospital of Baltimore, Baltimore, MD, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Berg
authors.affiliation: Infection Prevention and Control, Sinai Hospital of Baltimore, Baltimore, MD, USA.
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Daley
authors.affiliation: Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Jan
authors.initials: J
authors.lastname: Fritz
authors.affiliation: Department of Rehabilitation, Sinai Hospital of Baltimore, Baltimore, MD, USA.
authors.forename: Anil
authors.initials: A
authors.lastname: Bhave
authors.affiliation: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, USA. Electronic address: mmont@lifebridgehealth.org.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D003646:Debridement; D006801:Humans; D017053:Infection Control; D007595:Joint Prosthesis / Q000009:adverse effects*; D019990:Perioperative Care; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D012086:Reoperation; D012307:Risk Factors; D007507:Therapeutic Irrigation
chemical_list: D000900:Anti-Bacterial Agents