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Updated: Apr 14, 2026
Author Spotlight: Advancing Research on Candida albicans Biofilm-Associated Prosthetic Joint Infections
Published on: February 2, 2024
Fungal periprosthetic joint infection of the hip: a systematic review
Benjamin Schoof1, Oliver Jakobs1, Stefan Schmidl1
1Department of Orthopedic Surgery, HELIOS Endo-Clinic Hamburg , Hamburg, Germany.
Abstract:
Periprosthetic joint infection (PJI) is a severe complication of total joint arthroplasty with an incidence of approximately 1%. Due to the high risk of persisting infection, successful treatment of fungal PJI is challenging. The purpose of this study was to gain insight into the current management of fungal PJI of the hip and, by systematically reviewing the cases published so far, to further improve the medical treatment of this serious complication of total hip arthroplasty. Thus, we conducted a systematic review of the available literature concerning fungal PJI in total hip arthroplasty, including 45 cases of fungal PJI. At the moment a two-stage revision procedure is favorable and there is an ongoing discussion on the therapeutic effect of antifungal drug loaded cement spacers on fungal periprosthetic infections of the hip. Due to the fact that there is rare experience with it, there is urgent need to establish guidelines for the treatment of fungal infections of total hip arthroplasty.
Insights
Fungal periprosthetic joint infection (PJI) after hip replacement is challenging to treat. A review of 45 cases suggests a two-stage revision is favorable, but guidelines are needed for fungal PJI management.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Medical Mycology
Background:
- Periprosthetic joint infection (PJI) is a serious complication following total joint arthroplasty, occurring in approximately 1% of cases.
- Fungal PJI presents unique challenges due to the high risk of persistent infection and limited treatment options.
Purpose of the Study:
- To investigate the current management strategies for fungal PJI specifically in total hip arthroplasty.
- To systematically review published cases to identify effective treatments and areas for improvement.
Main Methods:
- A systematic literature review was conducted.
- Analysis included 45 reported cases of fungal PJI in total hip arthroplasty.
Main Results:
- The two-stage revision procedure is currently the favored approach for managing fungal PJI of the hip.
- There is ongoing debate regarding the efficacy of antifungal drug-loaded cement spacers in treating these infections.
Conclusions:
- Experience with fungal PJI in total hip arthroplasty is limited, highlighting a critical need for established treatment guidelines.
- Further research and data collection are essential to optimize the medical management of fungal periprosthetic hip infections.
