Diagnostic criteria of periprosthetic joint infection: a prospective study protocol to validate the feasibility of the 2018 new definition for Chinese patients

Table 1 New scoring based definition for periprosthetic joint infection (PJI)

Major criteria (at least one of the following)				Decision
Two positive cultures of the same organism				Infected
Sinus tract with evidence of communication to the joint or visualization of the prosthesis
Preoperative Diagnosis	Minor criteria		Score	Decision
	Serum	Elevated CRP or D-Dimer	2	≥6 Infected 2–5 Possibly Infected^a 0–1 Not Infected
		Elevated ESR	1
	Synovial	Elevated Synovial WBC or LE	3
		Positive Alpha-defensin	3
		Elevated Synovial PMN (%)	2
		Elevated Synovial CRP	1
Intraoperative Diagnosis	^aInconclusive pre-op score or dry tap		Score	Decision
	Preoperative Score		–	≥6 Infected 4–5 Inconclusive^b ≤3 Not Infected
	Positive Histology		3
	Positive Purulence		3
	Single Positive Culture		2

Proceed with caution in: Adverse local tissue reaction, crystal deposition disease, slow growing organisms
^aFor patients with inconclusive minor criteria, operative criteria can also be used to fulfill definition for PJI
^bConsider further molecular diagnostics such as next-generation sequencing

ISSN: 1471-2474