A Simple, Inexpensive, One-Minute Tool to Help Diagnose Periprosthetic Infection

Total hip or knee joint replacement has been one of the great gifts of medicine to mankind. Millions of individuals who would otherwise spend the remainder of their life inactive, limping painfully with a stick or crutches or wheelchair-bound, can now live relatively painless, enjoyable, productive lives. However, the physical and emotional devastation that is wreaked if an infection involving the total joint replacement occurs is almost immeasurable1. Morbidity is substantial and may be permanent. In addition, if revision arthroplasty is required, the mortality rate is elevated and the economic cost to the hospital averages almost four times that of a primary joint replacement2. On the average, a total hip or knee replacement endures about one million cycles of use per year. As a result, these mechanical devices would be expected to eventually loosen and/or wear out. This gradual process may take one or more decades. Bone cement may loosen, and high-density polyethylene spacers may wear down to create pseudo-laxity of the ligaments. The polyethylene wear-particle debris will also excite an erosive inflammatory reaction that further exacerbates the wear process. A …