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Abstract：
The diagnosis of periprosthetic joint infections (PJI) presents a formidable challenge to orthopaedic surgeons due to its complex and diverse manifestations. Accurate diagnosis is of utmost importance, as even mild pain following joint replacement surgery may indicate PJI in the absence of a definitive gold standard diagnostic test. Numerous diagnostic modalities have been suggested in the literature, and international societies have continually updated diagnostic criteria for this debilitating complication. This review article aims to comprehensively examine the latest evidence-based approaches for diagnosing PJI. Through a thorough analysis of current literature, we explore promising diagnostic strategies that have demonstrated effectiveness in identifying PJI. These strategies encompass the utilization of laboratory markers, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), alongside imaging techniques such as magnetic resonance imaging (MRI) and leukocyte scintigraphy. Additionally, we highlight the importance of synovial fluid analysis, including the potential role of alpha-defensin as a biomarker, and examine evolving international diagnostic criteria to standardize and improve diagnostic accuracy.
摘要：
假体周围感染（PJI）的诊断由于其复杂多样的表现而对整形外科医生提出了巨大的挑战。准确的诊断至关重要，因为在没有明确的金标准诊断测试的情况下，即使关节置换手术后的轻度疼痛也可能表明PJI。文献中提出了许多诊断方式，国际社会不断更新这种使人衰弱的并发症的诊断标准。本文旨在全面研究最新的基于证据的PJI诊断方法。通过对当前文献的深入分析，我们探索了在识别PJI方面已证明有效的有希望的诊断策略.这些策略包括利用实验室标记，如红细胞沉降率（ESR）和C反应蛋白（CRP），除了成像技术，如磁共振成像（MRI）和白细胞闪烁显像。此外,我们强调滑液分析的重要性，包括α-防御素作为生物标志物的潜在作用，并研究不断发展的国际诊断标准，以标准化和提高诊断准确性。
