Table 5 Infectious Diseases Society of America (IDSA) criteria

1. The presence of a sinus tract that communicates with the prosthesis

2. The presence of acute inflammation based on histopathologic examination of periprosthetic tissue at the time of surgical debridement or prosthesis removal.

3. The presence of purulence surrounding the prosthesis.

4. Two or more intraoperative cultures or combination of preoperative aspiration and intraoperative cultures that yield the same organism. Growth of a virulent microorganism (eg, S. aureus) in a single specimen of a tissue biopsy or synovial fluid may also represent PJI.

5. The presence of PJI is possible even if the above criteria are not met; the clinician should use his/her clinical judgment to determine if this is the case after reviewing all the available preoperative and intraoperative information