Published online May 25, 2017. doi: 10.5495/wjcid.v7.i2.11
Peer-review started: August 29, 2016
First decision: November 21, 2016
Revised: December 6, 2016
Accepted: January 20, 2017
Article in press: January 22, 2017
Published online: May 25, 2017
Processing time: 269 Days and 15 Hours
Periprosthetic joint infection (PJI) is considered one of the most challenging complications compromising patient health and is considered an economic burden. Despite all strategies PJI prevalence is between 1%-2%. Considerable efforts have been investigated in the past decade to diminish or erradicate PJI prevalence. This article manages the definition of PJI and the new major and minor criteria from Parvizi et al Then a scientific analysis of every minor and major criteria. Multidisciplinary management is reccommended according to guidelines. A numerous of surgical options exist each and everyone with its indications, contraindications and specific antibiotic therapy regimen. Surgical options are: (1) irrigation and cleaning with retention of the prosthesis with a success rate 0%-89%; (2) single-stage revision surgery with a succes rate of > 80%; and (3) two-stage revision surgery (authors preferred method) with a succes rate of 87%. Radical treatment options like arthrodesis and amputation are reserved for specific group of patients, with a succes rate varying from 60%-100%. The future of PJI is focused on improving the diagnostic tools and to combat biofilm. The cornerstone of management consists in a rapid diagnosis and specific therapy. This article presents the most current diagnostic and treatment criteria as well as the different surgical treatment options depending on the type of infection, bacterial virulence and patient comorbidities.
Core tip: The total replacement surgery is a highly effective surgery that improves the quality of life of patients. The periprosthetic infection is considered a devastating complication that increases patients morbidity, mortality and an economic burden. The cornerstone of management consists in a rapid diagnosis and specific therapy. This article presents the most current diagnostic and treatment criteria, as well as the different surgical treatment options depending on the type of infection, bacterial virulence and patient comorbidities.