ArticleActa orthopaedica2023
The European Bone and Joint Infection Society definition of periprosthetic joint infection is meaningful in clinical practice: a multicentric validation study with comparison with previous definitions.
Article in Acta orthopaedica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
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44 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Diagnostic accuracy of the monocyte-to-lymphocyte ratio in periprosthetic joint infection: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2025Pooled it
- Risk of surgical site infection after hip hemiarthroplasty of femoral neck fractures: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2024Pooled it
- Convergent methodologies in prosthetic joint infection research: integrating transdisciplinary approaches to understand and prevent biofilm-driven failure of orthopaedic prostheses.Journal of medical microbiology · 2026Review
- Does Aspiration With Culture Augmented With Percutaneous Core Biopsy Analysis Have Better Diagnostic Value Than Culture Alone for PJI in Large Joints? A Prospective Enhancement and Feasibility Study.Clinical orthopaedics and related research · 2026Article
- Unlocking Value: A Cost-Effectiveness Analysis of Hip PJI Diagnostic Pathways Employing the European Bone and Joint Infection Society/Musculoskeletal Infection Society Definition.Arthroplasty today · 2026Article
- Geographical Differences in the Epidemiology and Treatment of Candida Prosthetic Joint Infections.Open forum infectious diseases · 2026Article
- Reinfection and complication rates in two-stage revision for chronic hip periprosthetic joint infections using the direct anterior approach.Journal of bone and joint infection · 2026Article
- Gram-negative prosthetic joint infections: a retrospective multicentre European study of incidence, risk factors, and treatment outcomes.Journal of bone and joint infection · 2026Article
- High intra- and inter-observer reliability of the PJI-TNM classification in acute and chronic periprosthetic hip joint infection.Journal of bone and joint infection · 2026Article
- The presence of persistent synovial inflammation after "Eradication" unmasks the "Unseen" dormant state of infection allowing the prediction of infection free survival in total joint replacements.Journal of translational medicine · 2025Article
- Periprosthetic Joint Infection in Patients with Benign Prostatic Hyperplasia: A Systematic Review and Meta-analysis.Hip & pelvis · 2025Review
- Diagnostic Performance of Serum Neutrophil-Lymphocyte and Serum Monocyte-Lymphocyte Ratios in Periprosthetic Joint Infection: A Comparative Meta-Analytic Review of 29 Studies.Journal of clinical medicine · 2025Review
- Beyond Cultures: The Evolving Role of Molecular Diagnostics, Synovial Biomarkers and Artificial Intelligence in the Diagnosis of Prosthetic Joint Infections.Journal of clinical medicine · 2025Review
- The Impact of Antibiotic Therapy Options and Multidisciplinary Approach in Prosthetic Joint Infections.Microorganisms · 2025Article
- Significant differences in the rate of periprosthetic joint infections in revision hip and knee arthroplasty depending on the applied definition.Archives of orthopaedic and trauma surgery · 2025Article
- The Ongoing Struggle to Find a Gold Standard for PJI Diagnosis.Reports (MDPI) · 2025Review
- Evaluating the Risk of Postoperative Infection and Complications in Lumbar Spine Surgery Patients with Preoperative Methicillin-resistant Staphylococcus aureus (MRSA) Colonization.Archives of orthopaedic and trauma surgery · 2025Article
- 5- months exposed implant after osteosynthesis is not necessarily a problem: A case report of a distal tibia fracture.Trauma case reports · 2025Article
- Changing Incidence, Aetiology and Outcomes of Prosthetic Joint Infections: A Population-Based Study in Iceland.Journal of clinical medicine · 2025Article
- Evaluation of sonication for the detection of periprosthetic joint infection in hip revision arthroplasty: a retrospective observational single-center study of 288 episodes.Acta orthopaedica · 2025Observational
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9 authors.
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Abstract
background and purposeA new periprosthetic joint infection (PJI) definition has recently been proposed by the European Bone and Joint Infection Society (EBJIS). The goals of this paper are to evaluate its diagnostic accuracy and compare it with previous definitions and to assess its accuracy in preoperative diagnosis. PATIENTS AND
methodsWe retrospectively evaluated a multicenter cohort of consecutive revision total hip and knee arthroplasties. Cases with minimum required diagnostic workup were classified according to EBJIS, 2018 International Consensus Meeting (ICM 2018), Infectious Diseases Society of America (IDSA), and modified 2013 Musculoskeletal Infection Society (MSIS) definitions. 2 years' minimum follow-up was required to assess clinical outcome.
resultsOf the 472 cases included, PJI was diagnosed in 195 (41%) cases using EBJIS; 188 (40%) cases using IDSA; 172 (36%) using ICM 2018; and 145 (31%) cases using MSIS. EBJIS defined fewer cases as intermediate (5% vs. 9%; p = 0.01) compared with ICM 2018. Specificity was determined by comparing risk of subsequent PJI after revision surgery. Infected cases were associated with higher risk of subsequent PJI in every definition. Cases classified as likely/confirmed infections using EBJIS among those classified as not infected in other definitions showed a significantly higher risk of subsequent PJI compared with concordant non-infected cases using MSIS (RR = 3, 95% CI 1-6), but not using ICM 2018 (RR = 2, CI 1-6) or IDSA (RR = 2, CI 1-5). EBJIS showed the highest agreement between pre-operative and definitive classification (k = 0.9, CI 0.8-0.9) and was better at ruling out PJI with an infection unlikely result (sensitivity 89% [84-93], negative predictive value 90% [85-93]).
conclusionThe newly proposed EBJIS definition emerged as the most sensitive of all major definitions. Cases classified as PJI according to the EBJIS criteria and not by other definitions seem to have increased risk of subsequent PJI compared with concordant non-infected cases. EBJIS classification is accurate in ruling out infection preoperatively.
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