Reducing periprosthetic joint infection: what really counts?

Area of Science:

• Orthopedic surgery
• Infectious diseases
• Biomaterials science

Background:

• Periprosthetic joint infection (PJI) is a significant complication following joint arthroplasty, leading to implant failure and revision surgeries.
• Despite advancements, PJI incidence remains a challenge, influenced by host and bacterial factors across all surgical phases.
• Effective prevention strategies are crucial to mitigate this complication.

Purpose of the Study:

• To review and synthesize current knowledge on preoperative risk factors for periprosthetic joint infection (PJI).
• To provide a comprehensive understanding of host-related and bacterial factors influencing PJI development.
• To guide the identification and management of preoperative risk factors for PJI prevention.

Main Methods:

• Systematic literature review focusing on the preoperative period of joint arthroplasty.
• Analysis of studies identifying human host-related and bacterial agent-related risk factors for PJI.
• Synthesis of evidence regarding the interaction of these factors in PJI pathogenesis.

Main Results:

• Identified key preoperative risk factors in patients undergoing joint arthroplasty.
• Highlighted the complex interplay between patient-specific conditions and bacterial virulence in PJI.
• Emphasized the critical role of the preoperative phase in PJI prevention strategies.

Conclusions:

• Understanding and addressing preoperative risk factors is paramount for minimizing PJI incidence.
• Proactive management of identified risk factors can significantly reduce the likelihood of PJI and subsequent revision surgery.
• A comprehensive preoperative assessment is essential for successful joint arthroplasty outcomes.