Table 2 Proposed 2018 ICM criteria for PJI (modified version of the 2018 new definition)
Major criteria (at least one of the following) | Decision | |||
Two positive growth of the same organism using standard culture methods | Infected | |||
Sinus tract with evidence of communication to the joint or visualization of the prosthesis | ||||
Minor Criteria | Threshold | Score | Decision | |
Acuteb | Chronic | Combined preoperative and postoperative score: ≥6 Infected 3–5 Inconclusivea <3 Not Infected | ||
Elevated CRP (mg/L) | 100 | 10 | 2 | |
or | Â | Â | ||
D-Dimer (ug/L) | Unknown | 860 | ||
Elevated Serum ESR (mm/hr) | No role | 30 | 1 | |
Elevated Synovial WBC (cells/μL) | 10,000 | 3000 | 3 | |
or | Â | Â | ||
Leukocyte Esterase | ++ | ++ | ||
Or | Â | Â | ||
Positive Alpha-defensin (signal/cutoff) | 1.0 | 1.0 | ||
Elevated Synovial PMN (%) | 90 | 70 | 2 | |
Single Positive Culture | 2 | |||
Positive Histology | 3 | |||
Positive Intraoperative Purulencec | 3 | |||