[Revision strategy for periprosthetic infection]

Area of Science:

• Orthopedic surgery
• Infectious diseases
• Biomaterials science

Context:

• Periprosthetic joint infection (PJI) is a growing complication following joint replacement surgeries.
• Increasing numbers of primary and revision arthroplasties correlate with a rise in PJI cases.
• Effective management necessitates tailored treatment strategies for each patient.

Purpose:

• To outline diagnostic challenges and treatment concepts for periprosthetic infections.
• To differentiate management approaches based on the timing and chronicity of infection.
• To emphasize the importance of surgical intervention and individualized treatment planning.

Summary:

• Diagnosis of PJI requires a comprehensive approach utilizing various investigations.
• Early and secondary infections may allow for component retention with successful surgical debridement.
• Late and chronic infections typically necessitate explantation due to biofilm-producing microbes, with single-stage or two-stage revision chosen based on patient factors and surgeon expertise.

Impact:

• Highlights the critical role of timely and appropriate surgical intervention in managing PJI.
• Underscores the need for individualized treatment plans, balancing component retention versus revision.
• Suggests that while new diagnostic and therapeutic advancements are beneficial, prophylactic measures remain paramount.