The Persistent Challenges of Diagnosing Orthopaedic Implant-Related Infections.

J Bone Joint Surg Am · Apr 22 2026 · Review

Lum ZC, Cohen-Rosenblum A, Yao JJ, Chen AF, Landy DC, Parvizi J

Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York

General Orthopaedics

SUMMARY — THE REDUCTIONThis review outlines why diagnosing orthopaedic implant-related infection remains difficult despite advances in biomarkers and molecular testing, given biological variability and lack of a true gold standard, and summarizes emerging diagnostic approaches.
Abstract, as published

Infection remains one of the most catastrophic complications following orthopaedic surgery. Despite substantial advances in molecular diagnostics, biomarker assays, and consensus definitions, accurately diagnosing orthopaedic infection continues to challenge even the most experienced clinicians. There are differences in the diagnosis and treatment of infections that are related to different anatomic regions. The difficulty arises from the inherent biological diversity of infecting organisms and surgical locations, variable host responses, and the absence of a true diagnostic "gold standard." This article summarizes the current diagnostic challenges and emerging solutions, drawing on recent high-impact evidence and consensus frameworks.

Featured in the 2026-09-18 issue.

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