What is the diagnostic accuracy of joint aspiration of a cement spacer in conjunction with clinical evaluation, imaging, serologic tests, and biopsies? Should it routinely be performed prior to reimplantation?

Authors: Hangama Fayaz, Carlos A. Higuera, Igor Shubnyakov
RECOMMENDATION: The diagnostic accuracy of joint aspiration prior to reimplantation is not known. None of the parameters being used to diagnose periprosthetic joint infection (PJI), and their respective thresholds, have been determined for aspiration. The decision to perform aspiration should be made based on the index of suspicion for persistent infection and individualized.
LEVEL OF EVIDENCE: Moderate
DELEGATE VOTE: Agree: 95%, Disagree: 4%, Abstain: 1% (Unanimous, Strongest Consensus)

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