The new evidence-based 2018 International Consensus Meeting (ICM) definition for diagnosing periprosthetic joint infection (knee and hips).
|1. Two + cultures (same microorganism)||Interpretation|
|2. Sinus tract communicating with the joint or if joint prosthesis is visualized
||At least one of these: Infected
|A. Preoperative diagnosis||Score||Interpretation|
|1. ↑CRP (more than 1 mg/dL) OR D-Dimer (more than 860 ng/mL)||2||≥6: Infected|
|2. ↑ESR (more than 30 mm/h)||1||2–5: Possibly infected|
|Synovial||0–1: Not Infected|
|1. ↑Synovial WBC count (more than 3000 cells/μL) or LE ++||3|
|2. +Alpha-defensin (signal-to-cut-off ratio > 1)||3|
|3. ↑Synovial PMN (%) (more than 80%)||2|
|4. ↑Synovial CRP (more than 6.9 mg/L)||1|
|B. Intraoperative diagnosis||≥6: Infected|
|1. Preoperative score||–||4–5: Inconclusive|
|2. +Histology||3||≤3: Not Infected|
|4. One + Culture||2|
C-reactive protein (CRP); erythrocyte sedimentation rate (ESR); positive (+); ↑: increase; polymorphonuclear neutrophils (PMN).
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