Challenges in periprosthetic knee-joint infection

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Biomedical Engineering

Background:

• Knee arthroplasty procedures are increasing globally.
• Periprosthetic joint infection (PJI) risk, though low (<1%), poses a growing challenge due to rising procedure numbers and patient comorbidities.
• Lifelong risk of hematogenous infection contributes to the increasing incidence of PJI.

Purpose of the Study:

• To review current literature and author experience regarding unresolved questions in knee PJI management.
• To analyze recent data on PJI incidence, risk factors, and microbiology.
• To provide insights into debridement surgery, spacer use, and antimicrobial therapy duration for knee PJI.

Main Methods:

• Comprehensive literature review of available studies on knee periprosthetic joint infection.
• Analysis of recent epidemiological data, risk factors, and microbiological findings related to PJI.
• Synthesis of author experience and current treatment concepts for knee PJI.

Main Results:

• The total number of PJI cases is expected to increase despite a low individual risk.
• Key areas requiring further investigation include debridement strategies for implant retention, microbiological role of spacers, and optimal antibiotic treatment duration.
• Recent data highlights evolving trends in PJI risk factors and causative microorganisms.

Conclusions:

• Addressing unresolved questions in knee PJI management is crucial for improving patient outcomes.
• Continued research and evidence-based strategies are needed to combat the rising incidence of knee PJI.
• Optimal treatment protocols for knee PJI require further refinement based on microbiological insights and clinical evidence.