Periprosthetic joint infections in Orthopaedics

Periprosthetic joint infections (PJIs) represent a serious complication following primary arthroplasty, with an incidence varying between 1% and 2%. The reason behind the high morbidity rates is the formation of biofilms on arthroplasty implants that renders antibiotic treatment less effective. With the advent of new diagnostic modalities, such as sonication, and sophisticated diagnostic criteria, sensitivity and specificity for diagnosing this post-operative complication has increased immensely. Treatment of PJIs involves a multi-disciplinary approach, including but not limited to orthopaedic surgeons, plastic surgeons, microbiologists, and physiotherapists. Depending on the chronicity of this problem, options could vary from debridement and implant retention to single or two stage revision, with the latter being the gold standard of treatment. Success rates following two stage revision could be as high as 80-100%, as long as all treatment principles are respected. The maximum recommended antibiotic treatment should not exceed 12 weeks, when it comes to revision arthroplasty surgery.