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Periprosthetic Joint Infection: Diagnosis and Management
Periprosthetic joint infection (PJI) is a substantial complication after total hip arthroplasty (THA). PJI is diagnosed in 15% of revision THAs in the United States and 13% in the United Kingdom. Complications resulting from PJI occur in approximately 0.88% to 2.22% of primary THAs and 4% to 6% of revision THAs. PJI continues to occur despite the use of a clean-air operating room, perioperative antibiotics, and numerous other measures. Patients with PJI of the hip often require multiple surgical procedures, prolonged use of intravenous and oral antibiotics, and extended inpatient and outpatient rehabilitation. Clinical outcomes are worse in patients who undergo revision of an infected THA than in patients who undergo revision for aseptic failure. Recently, PJI has been found to increase patient mortality fivefold compared with that of patients with aseptic failure.