Osmon et al listed criteria for the diagnosis of prosthetic joint infection (PJI). The authors are from multiple institutions from Europe and the United States and from the Infectious Diseases Society of America.
Patient selection: prosthetic joint present
A prosthetic joint infection is present if one or more of the following are identified:
(1) sinus tract communicating with the prosthesis (definitive)
(2) presence of purulence surrounding the prosthesis without another known etiology (definitive)
(3) acute inflammation on histopathologic exam of periprosthetic tissue (highly suggestive)
(4) >= 2 positive cultures with the same organism (definitive)
(5) 1 positive culture with a virulent organism (highly suggestive)
The presence of PJI is possible even if all of the above are negative. A clinical diagnosis can be made based on evaluation of all available preoperative and intraoperative information.
where:
• A single isolate of a common contaminant in culture is not sufficient for the diagnosis.
• Culture isolates are considered "the same" if indistinguishable based on common laboratory tests, including antibiogram.
