What is the prevalence of culture-negative periprosthetic join infections (CN-PJIs) and what are the diagnostic protocols for further investigating these cases?

Authors: Karan Goswami, Yong-Chan Ha, Marie-Jacque Reisener, Carsten Perka, Pedro Foguet

RECOMMENDATION: The reported prevalence of CN-PJIs in the hip or knee has ranged from 5-42%. Diagnostic protocols for further investigating these cases include repeat sampling, longer incubation of culture samples, sonication of implants, the use of dithiothreitol (DTT) technology, polymerase chain reaction (PCR) and next generation sequencing (NGS).

LEVEL OF EVIDENCE: Moderate

DELEGATE VOTE: Agree: 91%, Disagree: 8%, Abstain: 1% (Super Majority, Strong Consensus)