How is septic arthritis of prosthetic joints differentiated from low-grade-chronic periprosthetic joint infection?

Updated: Oct 06, 2020
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Answer

General recommendations and empiric therapeutic regimens for septic arthritis of prosthetic joints, or periprosthetic joint infection (PJI), are provided below, based on Gram stain results. [1, 2, 3, 4, 5, 6, 7]

It is difficult to differentiate aseptic loosening of prosthetic joints from low-grade-chronic periprosthetic joint infections. Measurement of circulating biomarkers code hold promise in making these determinations. The specificity of procalcitonin measurements is low in these situations (27.8%). The combination of a C-reactive protein (CRP) level [8] greater than 0.3 mg/dL and IL-6 level greater than 5.12 pg/mL is superior, with a sensitivity of 75% and specificity of 98.2% in high-risk patients. [9, 10]


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