Comparison of the Diagnostic Performance of Culture, Histopathology, and mNGS for Periprosthetic Joint Infection Using Periprosthetic Tissue Samples: A Prospective Clinical Study

mNGS shows promise as a complementary tool for diagnosing PJI, especially in culture-negative or atypical cases. However, it did not outperform conventional methods in accuracy. Its limitations-including a high false-positive rate, interpretive challenges, and lack of susceptibility data-warrant cautious use. Further large-scale studies are needed to define its role in clinical decision-making.