Infections in Hip and Knee Arthroplasty: Challenges to and Chances for the Microbiological Laboratory

Comprehensive algorithms have been devised to improve the management of periprosthetic joint infections of the hip and the knee (Gomez & Patel, 2011a, 2011b; Peel et al., 2011). There is still no single best method for diagnosis, as stressed for instance in a guideline published recently by the American Association of Orthopedic Surgeons (AAOS) (Della Valle et al., 2010). An important reason for this is lacking consensus on how to define arthroplasty infection accurately. Nevertheless, it is beyond dispute that microbiologic techniques play a key role in assessment for these infections. The chapter consists of three sections. Firstly, a general introduction to the special nature of arthroplasty infection is given, which highlights the necessity of reliable microbiological diagnostics. Secondly, a critical appraisal of the various technical and interpretive aspects of microbiologic procedures is featured. Thirdly, our own diagnostic approaches are presented, and a prospect on probable useful developments in the future is offered.