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The American Academy of Orthopaedic Surgeons Clinical Practice Guideline "Diagnosis and Prevention of Periprosthetic Joint Infections (PJI)" is a summary of the available literature designed to help guide surgeons and other qualified physicians in the management of PJI. Obesity and intra-articular joint injections are associated with an increased risk of PJI according to this Clinical Practice Guideline. Serum erythrocyte sedimentation rate, C-reactive protein, and/or interleukin-6 should be obtained when diagnosing PJI. Synovial fluid leukocyte count, neutrophil percentage, aerobic and anaerobic bacterial cultures, leukocyte esterase, alpha-defensin, C-reactive protein, and nucleic acid amplification testing may assist with the diagnosis of PJI. Antibiotics should be held for 2 weeks before obtaining samples. Intraoperatively, Gram stains do not help with PJI diagnosis, whereas histopathology samples are helpful. These guidelines may help clinicians with the prevention and diagnosis of PJI.
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PMID:A Case Illustrating the Practical Application of the AAOS Clinical Practice Guideline: Diagnosis and Prevention of Periprosthetic Joint Infection. 3299 85


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