Emerging diagnostic tools for periprosthetic joint infections

Arthroplasty has been applied widely to patients with degenerative or injured joints. The success rate of arthroplasty is as high as 95% and greatly improves the quality of life among patients. However, the complications which occur after the surgery namely, periprosthetic joint infections (PJI) are very difficult to treat. Conventional methods such as microbiological culture and white blood cell counts have been commonly used in hospitals to diagnose PJI. The shortcomings of these conventional methods are relatively time-consuming or poor sensitivity/specificity. To overcome the limitations, alternative diagnosis approaches such as enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) have been applied to detect PJI. Among these diagnostic methods, PCR is the most widely used method in PJI molecular diagnosis with diverse applications for a variety of scenarios. Although the sensitivity and specificity of real-time PCR can be higher than 90% when appropriate primers are chosen, false-positive issues may arise in the presence of dead bacteria or contamination since this method cannot distinguish dead and live bacteria. Recently, the field of micro-electro-mechanical-systems (MEMS) and microfluidic technologies has emerged as promising tools and integrated micro total-analysis-systems have been applied to the diagnosis of PJI in order to overcome the false-positive problem. The aim of this review article is to analyze different diagnostic strategies which have been applied for the diagnosis of PJI and provide insights into the future.

並列關鍵字

periprosthetic joint infections ； polymerase chain reaction ； enzyme-linked immunosorbent assay ； micro-electro-mechanical-systems ； microfluidics

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