Table 2
The new evidence-based 2018 International Consensus Meeting (ICM) definition for diagnosing periprosthetic joint infection (knee and hips).
| Major criteria | ||
|---|---|---|
| 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 |
|
| Minor criteria |
||
| A. Preoperative diagnosis | Score | Interpretation |
| Serum | ||
| 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 |
| 3. +Purulence | 3 | |
| 4. One + Culture | 2 | |
C-reactive protein (CRP); erythrocyte sedimentation rate (ESR); positive (+); ↑: increase; polymorphonuclear neutrophils (PMN).
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