Microfluidics for Periprosthetic Joint Infection (PJI) Detection: Summaries and Future Perspectives

Periprosthetic joint infection (PJI) is a severe and difficult-to-treat complication following artificial joint replacement, occurring in approximately 1–2% of total joint arthroplasties and normally caused by the adhesion of bacteria to the prosthesis and the formation of biofilms. Since this disease lacks a single definitive diagnostic indicator, a comprehensive judgment needs to be made by combining serum inflammatory indicators, joint synovial fluid tests, microbial cultures, imaging, and intraoperative pathology. Although microbial culture remains the gold standard, it usually requires more than 3 days. Microfluidics breaks through the limitations of traditional cultivation and conventional nucleic acid testing, which are characterized by long time consumption, large sample requirements, complex operations, and bulky equipment. Microfluidics has the irreplaceable advantage in real-time, micro-scale, and multi-indicator synchronous detection of bacterial pathogens, while the serious consequences of PJI require more advanced and rapid detection technologies to enable more effective treatment. In this review, in addition to summarizing the advances of microfluidic technology in the field of bacterial detection over the past five years, we also propose and analyze the microfluidic technology strategies that are likely to develop in the field of PJI detection in the future.