Prosthetic joint infections: microbiology, diagnosis, management and prevention

Infections associated with prosthetic joints occur less frequently than aseptic failures but represent the most devastating complication, with high morbidity and substantial cost. The most important risk factors are co-morbidity and prior joint replacement ( revision surgery). No single routinely used clinical or laboratory test has been shown to achieve ideal sensitivity, specificity and accuracy for the diagnosis of prosthetic joint infection ( PJI). Therefore, only the sum of clinical signs and symptoms, blood tests, histopathology, radiography, bone scans and a microbiological work-up can provide an accurate diagnosis. Antimicrobial therapy must always be combined with the correct surgical treatment, which is chosen according to the duration of the infection and co-morbidities of the patient. This review will briefly discuss the microbiology, diagnosis, management and prevention of PJI. (C) 2008 Elsevier B. V. and the International Society of Chemotherapy. All rights reserved.