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Periprosthetic Infection: What Are the Diagnostic Challenges?
Javad Parvizi, MD, FRCS; Elie Ghanem, MD; Sarah Menashe, BS; Robert L. Barrack, MD; Thomas W. Bauer, MD, PhD
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The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Dec 01;88(suppl 4):138-147. doi: 10.2106/JBJS.F.00609
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Periprosthetic infection remains one of the most challenging complications of total joint arthroplasty. Despite the substantial reduction in the prevalence of this complication over the last two decades, periprosthetic infection is the second most common complication of joint arthroplasty, after loosening1,2. Infection has been reported to occur in association with 1% to 4% of primary total knee arthroplasties3,4 and about 1% of primary total hip arthroplasties5,6. The prevalence of periprosthetic infection after revision arthroplasty is much higher, reported to be 3.2% for hips and 5.6% for knees7. It is believed that the prevalence of periprosthetic infection is on the rise once again8. The treatment of periprosthetic infection differs vastly from the treatment of aseptic loosening. Hence, it is paramount to distinguish between septic and aseptic joint failures preoperatively.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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