Diagnosis of periprosthetic joint infection in revision total knee arthroplasty: review

The article is devoted to one of the most actual problems of modern orthopedics - the diagnosis of periprosthetic joint infection. The article presents modern views on various diagnostic methods and their combinations in identifying periprosthetic joint infection with an emphasis on a special group of patients who need revision knee arthroplasty due to aseptic loosening or in the presence of a spacer. The purpose of the review is to present the current views on the diagnosis of periprosthetic joint infection in patients requiring revision knee arthroplasty based on the analysis of the literature. Based on the analysis of the literature, it was concluded that the sensitivity and specificity of a number of diagnostic methods significantly decreases when examining patients before revision arthroplasty, which does not allow timely differentiation of aseptic loosening and latent periprosthetic joint infection or to evaluate the effectiveness of the second stage of PJI treatment before revision total knee arthroplasty. Improving diagnostic algorithms for a comprehensive examination of patients requiring revision surgery will likely allow timely detection or exclusion of latent periprosthetic joint infection and, if necessary, adjust the tactics of treating patients with identified infection.