Periprosthetic Infection: What Are the Diagnostic Challenges?

Periprosthetic infection remains one of the most challenging complications of total joint arthroplasty. Despite the substantial reduction in the prevalence of this complication over the last two decades, periprosthetic infection is the second most common complication of joint arthroplasty, after loosening1,2. Infection has been reported to occur in association with 1% to 4% of primary total knee arthroplasties3,4 and about 1% of primary total hip arthroplasties5,6. The prevalence of periprosthetic infection after revision arthroplasty is much higher, reported to be 3.2% for hips and 5.6% for knees7. It is believed that the prevalence of periprosthetic infection is on the rise once again8. The treatment of periprosthetic infection differs vastly from the treatment of aseptic loosening. Hence, it is paramount to distinguish between septic and aseptic joint failures preoperatively.