ReviewDer Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen2016
[Implant-associated infections - Diagnostics].
Review in Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed.
- [Aseptic loosening of total ankle replacement and conversion to ankle arthrodesis].Operative Orthopadie und Traumatologie · 2017Trial
- Exploring the Value of Paired Microbiology and Histology in Chronic Osteomyelitis and Fracture-Related Infections.Antibiotics (Basel, Switzerland) · 2025Article
- Efforts in surgical site infection surveillance at the Mbouo Protestant Hospital in Cameroon.BMC surgery · 2025Observational
- Advantages in orthopaedic implant infection diagnostics by additional analysis of explants.International orthopaedics · 2025Article
- HMGB-1 Levels in Painful Knee Arthroplasty: Is it Possible to Distingue Periprosthetic Joint Infection and Aseptic Loosening?Indian journal of orthopaedics · 2023Article
- Treatment outcomes of patients with Cutibacterium acnes-positive cultures during total joint replacement revision surgery: a minimum 2-year follow-up.Archives of orthopaedic and trauma surgery · 2023Article
- Antibiotic Prophylaxis in One-Stage Revision of Septic Total Knee Arthroplasty: A Scoping Review.Antibiotics (Basel, Switzerland) · 2023Article
- [Salvage options following failed total ankle arthroplasty].Der Unfallchirurg · 2022Review
- Diagnosis of Chronic Infection at Total Hip Arthroplasty Revision Is a Question of Definition.BioMed research international · 2021Article
- Clinical presentation and diagnosis of acute postoperative spinal implant infection (PSII).Journal of spine surgery (Hong Kong) · 2020Review
- Infection control and outcome of staged reverse shoulder arthroplasty for the management of shoulder infections.JSES international · 2020Article
- [Low-grade-infections after spondylodeses-A chameleon? : Current findings and therapeutic strategies].Der Orthopade · 2020Review
- [Implant-associated joint infections].Der Orthopade · 2020Article
- [Complication profile and revision concepts for megaprosthetic reconstruction following tumour resection at the hip].Der Orthopade · 2020Review
- [Management of complications following tumor endoprosthetic replacement].Der Orthopade · 2019Review
- Evaluation of the use of sonication of retrieved implants for the diagnosis of prosthetic joint infection in a routine setting.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2018Article
- Insufficient sensitivity of joint aspiration during the two-stage exchange of the hip with spacers.Journal of orthopaedic surgery and research · 2018Article
- Limited Predictive Value of Serum Inflammatory Markers for Diagnosing Fracture-Related Infections: results of a large retrospective multicenter cohort study.Journal of bone and joint infection · 2018Article
- [Reconstruction of osseous defects using the Masquelet technique].Der Orthopade · 2017Review
- C-reactive protein may misdiagnose prosthetic joint infections, particularly chronic and low-grade infections.International orthopaedics · 2017Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The diagnosis of implant-associated infections is challenging as chronic low-grade infections often only manifest as subtle clinical symptoms. Clinical evaluation, patient history, imaging, histopathological and microbiological examinations build the cornerstones of the diagnostics for implant-associated infections. New onset of pain at rest, local symptoms at the surgical site and early loosening of the prosthesis or pseudarthrosis should raise suspicion for an infection and prompt further evaluation. Percutaneous sinus tracts, purulent wound secretions and skin erosions with exposure of the implant are certain signs of implant-associated infections. Elevated C‑reactive protein levels in blood support the diagnosis of infection but are neither sufficient sensitive nor specific to confirm or exclude infection. Preoperative antibiotic therapy interferes with the diagnostic evaluation and should be avoided. In periprosthetic joint infections, joint aspiration with determination of the leukocyte count and microbiological examination is a crucial first diagnostic step. Through microbiological and histopathological examinations of intraoperative tissue samples, as well as sonication of explanted implants, the causative pathogen can be identified in most cases. In osteosynthesis-associated infections imaging plays a key role to detect non-union, infection callus, sequester, peri-implant osteolysis and extraosseous and intramedullary pathologies. In prosthetic joint infections imaging provides information about the position and stability of the prosthesis. In case of hematogenic infection seeding from a distant focus, blood cultures should be sampled, followed by a meticulous investigation of potential primary focus of infection, depending on the causative agent.
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