{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:34:29Z","timestamp":1777656869422,"version":"3.51.4"},"reference-count":43,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","clinicalkey.com.au","clinicalkey.fr","arthroplastyjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Arthroplasty"],"published-print":{"date-parts":[[2018,11]]},"DOI":"10.1016\/j.arth.2018.07.016","type":"journal-article","created":{"date-parts":[[2018,7,24]],"date-time":"2018-07-24T03:31:18Z","timestamp":1532403078000},"page":"3561-3566","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":35,"title":["Diagnosing Periprosthetic Joint Infection in Inflammatory Arthritis: Assumption Is the Enemy of True Understanding"],"prefix":"10.1016","volume":"33","author":[{"given":"Noam","family":"Shohat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karan","family":"Goswami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yale","family":"Fillingham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy L.","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler","family":"Calkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig J.","family":"Della Valle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaiben","family":"George","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Higuera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6985-5870","authenticated-orcid":false,"given":"Javad","family":"Parvizi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.arth.2018.07.016_bib1","doi-asserted-by":"crossref","first-page":"38","DOI":"10.2106\/JBJS.G.01686","article-title":"Risk factors for infection after knee arthroplasty. A register-based analysis of 43,149 cases","volume":"91","author":"J\u00e4msen","year":"2009","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2018.07.016_bib2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.arth.2008.10.013","article-title":"Incidence of prosthetic joint infections after primary knee arthroplasty","volume":"25","author":"J\u00e4msen","year":"2010","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2018.07.016_bib3","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/j.arth.2007.10.017","article-title":"Infection burden for hip and knee arthroplasty in the United States","volume":"23","author":"Kurtz","year":"2008","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2018.07.016_bib4","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1302\/0301-620X.88B7.17150","article-title":"The incidence of deep prosthetic infections in a specialist orthopaedic hospital: a 15-year prospective survey","volume":"88","author":"Phillips","year":"2006","journal-title":"J\u00a0Bone Joint Surg Br"},{"key":"10.1016\/j.arth.2018.07.016_bib5","first-page":"1746","article-title":"The impact of infection after total hip arthroplasty on hospital and surgeon resource utilization","volume":"87","author":"Bozic","year":"2005","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2018.07.016_bib6","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/00003086-200403000-00005","article-title":"Periprosthetic sepsis","volume":"420","author":"Della Valle","year":"2004","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2018.07.016_bib7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/00003086-200111000-00003","article-title":"Infection in total knee replacement: a retrospective review of 6489 total knee replacements","author":"Peersman","year":"2001","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2018.07.016_bib8","doi-asserted-by":"crossref","first-page":"2992","DOI":"10.1007\/s11999-011-2102-9","article-title":"New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society","volume":"469","author":"Parvizi","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2018.07.016_bib9","doi-asserted-by":"crossref","first-page":"771","DOI":"10.5435\/00124635-201012000-00007","article-title":"AAOS Clinical Practice Guideline: diagnosis and treatment of periprosthetic joint infections of the hip and knee","volume":"18","author":"Parvizi","year":"2010","journal-title":"J\u00a0Am Acad Orthop Surg"},{"key":"10.1016\/j.arth.2018.07.016_bib10","doi-asserted-by":"crossref","first-page":"760","DOI":"10.5435\/00124635-201012000-00006","article-title":"Diagnosis of periprosthetic joint infections of the hip and knee","volume":"18","author":"Della Valle","year":"2010","journal-title":"J\u00a0Am Acad Orthop Surg"},{"key":"10.1016\/j.arth.2018.07.016_bib11","doi-asserted-by":"crossref","first-page":"753","DOI":"10.2106\/JBJS.16.00123","article-title":"Synovial fluid cell count for diagnosis of chronic periprosthetic hip infection","volume":"99","author":"Higuera","year":"2017","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2018.07.016_bib12","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.2106\/JBJS.G.01255","article-title":"Perioperative testing for joint infection in patients undergoing revision total hip arthroplasty","volume":"90","author":"Schinsky","year":"2008","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2018.07.016_bib13","doi-asserted-by":"crossref","first-page":"2628","DOI":"10.1007\/s11999-008-0471-5","article-title":"Diagnosis of infected total knee: findings of a multicenter database","volume":"466","author":"Parvizi","year":"2008","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2018.07.016_bib14","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.2106\/JBJS.G.00470","article-title":"Cell count and differential of aspirated fluid in the diagnosis of infection at the site of total knee arthroplasty","volume":"90","author":"Ghanem","year":"2008","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2018.07.016_bib15","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.2106\/00004623-200707000-00001","article-title":"Use of erythrocyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arthroplasty. A prospective evaluation","volume":"89","author":"Greidanus","year":"2007","journal-title":"J\u00a0Bone Joint Surg Am"},{"issue":"6 Suppl.\u00a02","key":"10.1016\/j.arth.2018.07.016_bib16","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.arth.2007.04.013","article-title":"Preoperative testing for sepsis before revision total knee arthroplasty","volume":"22","author":"Della Valle","year":"2007","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2018.07.016_bib17","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.amjmed.2004.06.022","article-title":"Synovial fluid leukocyte count and differential for the diagnosis of prosthetic knee infection","volume":"117","author":"Trampuz","year":"2004","journal-title":"Am J Med"},{"key":"10.1016\/j.arth.2018.07.016_bib18","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/S0883-5403(03)00448-0","article-title":"The value of white blood cell counts before revision total knee arthroplasty","volume":"18","author":"Mason","year":"2003","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2018.07.016_bib19","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/S0883-5403(00)90578-3","article-title":"White blood cell counts and differential in synovial fluid of aseptically failed total knee arthroplasty","volume":"15","author":"Kersey","year":"2000","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2018.07.016_bib20","doi-asserted-by":"crossref","first-page":"672","DOI":"10.2106\/00004623-199905000-00008","article-title":"Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties","volume":"81","author":"Spangehl","year":"1999","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2018.07.016_bib21","first-page":"285","article-title":"Diagnosis of infection following total hip arthroplasty","volume":"47","author":"Spangehl","year":"1998","journal-title":"Instr Course Lect"},{"key":"10.1016\/j.arth.2018.07.016_bib22","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 rheumatoid arthritis classification criteria: an American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum"},{"key":"10.1016\/j.arth.2018.07.016_bib23","doi-asserted-by":"crossref","first-page":"594","DOI":"10.2106\/JBJS.J.01318","article-title":"Serum and synovial fluid analysis for diagnosing chronic periprosthetic infection in patients with inflammatory arthritis","volume":"94","author":"Cipriano","year":"2012","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2018.07.016_bib24","doi-asserted-by":"crossref","first-page":"S205","DOI":"10.1016\/j.arth.2017.12.018","article-title":"Utility of serological markers for detecting persistent infection in two-stage revision arthroplasty in patients with inflammatory arthritis","volume":"33","author":"George","year":"2018","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2018.07.016_bib25","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1302\/0301-620X.95B11.33135","article-title":"Proceedings of the International Consensus on Periprosthetic Joint Infection","volume":"95-B","author":"Parvizi","year":"2013","journal-title":"Bone Joint J"},{"key":"10.1016\/j.arth.2018.07.016_bib26","doi-asserted-by":"crossref","first-page":"2374","DOI":"10.1007\/s11999-013-2866-1","article-title":"Success after treatment of periprosthetic joint infection: a Delphi-based international multidisciplinary consensus","volume":"471","author":"Diaz-Ledezma","year":"2013","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2018.07.016_bib27","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1148\/radiology.148.3.6878708","article-title":"A\u00a0method of comparing the areas under receiver operating characteristic curves derived from the same cases","volume":"148","author":"Hanley","year":"1983","journal-title":"Radiology"},{"key":"10.1016\/j.arth.2018.07.016_bib28","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3","article-title":"Index for rating diagnostic tests","volume":"3","author":"Youden","year":"1950","journal-title":"Cancer"},{"key":"10.1016\/j.arth.2018.07.016_bib29","doi-asserted-by":"crossref","first-page":"2102","DOI":"10.2106\/JBJS.I.01199","article-title":"Inflammatory blood laboratory levels as markers of prosthetic joint infection: a systematic review and meta-analysis","volume":"92","author":"Berbari","year":"2010","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2018.07.016_bib30","doi-asserted-by":"crossref","first-page":"e444","DOI":"10.1016\/j.ijid.2009.02.017","article-title":"The use of receiver operating characteristics analysis in determining erythrocyte sedimentation rate and C-reactive protein levels in diagnosing periprosthetic infection prior to revision total hip arthroplasty","volume":"13","author":"Ghanem","year":"2009","journal-title":"Int J Infect Dis"},{"key":"10.1016\/j.arth.2018.07.016_bib31","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/j.arth.2012.11.006","article-title":"Utility of synovial fluid aspirations in failed metal-on-metal total hip arthroplasty","volume":"28","author":"Wyles","year":"2013","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2018.07.016_bib32","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.2106\/JBJS.J.00756","article-title":"Utility of intraoperative frozen section histopathology in the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis","volume":"94","author":"Tsaras","year":"2012","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2018.07.016_bib33","first-page":"229","article-title":"Frozen histologic section as a guide to sepsis in revision joint arthroplasty","author":"Fehring","year":"1994","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2018.07.016_bib34","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.arth.2004.06.034","article-title":"The role of intraoperative frozen section in decision making in revision hip and knee arthroplasties in a local community hospital","volume":"20","author":"Ko","year":"2005","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2018.07.016_bib35","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.2106\/00004623-199610000-00014","article-title":"The reliability of analysis of intraoperative frozen sections for identifying active infection during revision hip or knee arthroplasty","volume":"78","author":"Lonner","year":"1996","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2018.07.016_bib36","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1111\/j.1365-2559.2009.03313.x","article-title":"Twenty-three neutrophil granulocytes in 10 high-power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening","volume":"54","author":"Morawietz","year":"2009","journal-title":"Histopathology"},{"key":"10.1016\/j.arth.2018.07.016_bib37","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1080\/17453670710013726","article-title":"Frozen sections of samples taken intraoperatively for diagnosis of infection in revision hip surgery","volume":"78","author":"Nu\u00f1ez","year":"2007","journal-title":"Acta Orthop"},{"key":"10.1016\/j.arth.2018.07.016_bib38","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1016\/j.arth.2012.03.035","article-title":"How do frozen and permanent histopathologic diagnoses compare for staged revision after periprosthetic hip infections?","volume":"27","author":"Stroh","year":"2012","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2018.07.016_bib39","first-page":"383","article-title":"Revised consensus classification. Histopathological classification of diseases associated with joint endoprostheses","volume":"72","author":"Krenn","year":"2013","journal-title":"Z\u00a0Rheumatol"},{"key":"10.1016\/j.arth.2018.07.016_bib40","first-page":"83","article-title":"Diagnosing acute monoarthritis in adults: a practical approach for the family physician","volume":"68","author":"Siva","year":"2003","journal-title":"Am Fam Physician"},{"key":"10.1016\/j.arth.2018.07.016_bib41","first-page":"174","article-title":"Microbial infection and rheumatoid arthritis","volume":"4","author":"Li","year":"2013","journal-title":"J\u00a0Clin Cell Immunol"},{"key":"10.1016\/j.arth.2018.07.016_bib42","doi-asserted-by":"crossref","first-page":"e0180518","DOI":"10.1371\/journal.pone.0180518","article-title":"Gut bacterial peptides with autoimmunity potential as environmental trigger for late onset complex diseases: in-silico study","volume":"12","author":"Negi","year":"2017","journal-title":"PLoS One"},{"key":"10.1016\/j.arth.2018.07.016_bib43","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/1479-5876-12-77","article-title":"Infection risk in rheumatoid arthritis and spondyloarthropathy patients under treatment with DMARDs, corticosteroids and TNF-\u03b1 antagonists","volume":"12","author":"Germano","year":"2014","journal-title":"J\u00a0Transl Med"}],"container-title":["The Journal of Arthroplasty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540318306594?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540318306594?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T14:47:46Z","timestamp":1604674066000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0883540318306594"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":43,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["S0883540318306594"],"URL":"https:\/\/doi.org\/10.1016\/j.arth.2018.07.016","relation":{},"ISSN":["0883-5403"],"issn-type":[{"value":"0883-5403","type":"print"}],"subject":[],"published":{"date-parts":[[2018,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Diagnosing Periprosthetic Joint Infection in Inflammatory Arthritis: Assumption Is the Enemy of True Understanding","name":"articletitle","label":"Article Title"},{"value":"The Journal of Arthroplasty","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arth.2018.07.016","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2018 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}