Definition of Periprosthetic Joint Infection

摘要

Diagnosis of periprosthetic joint infection (PJI) remains challenging as no "gold standard" for diagnosis exists [3]. The challenge is then what test(s) or criterion(ia) can be used to define PJI. In an effort to standardize the definition of PJI, Musculoskeletal Infection Society (MSIS) convened a workgroup in 2011 to issue diagnostic criteria for PJI [1]. The MSIS definition of PJI consists of two major criteria, when the presence of either criterion would indicate PJI, and six minor criteria, when the presence of four or more would indicate PJI.In August 2013 a large group of experts convened together in Philadelphia as part of an International Consensus Meeting on PJI. The consensus group, consisting of 400 experts from 52 countries and over 130 societies, met just ahead of the annual meeting of the MSIS. The consensus group endorsed the MSIS definition of PJI and modified the MSIS criteria slightly by adding the leukocyte esterase test as a minor criterion (Table 1). The document generated by the consensus group, including the diagnostic criteria for PJI, has been adopted by over 130 societies and organizations [2]. The diagnostic criteria introduced by the MSIS and modified by the International Consensus group has been adapted by the Center for Disease Control and will replace the previous definition of PJI that was used by the National Healthcare Safety Network (NHSN), surveillance arm of the CDC.