[Periprosthetic Joint Infections - An Overview]

Area of Science:

• Orthopedics
• Infectious Diseases
• Surgical Innovation

Background:

• Periprosthetic joint infections (PJI) present a significant interdisciplinary challenge in patient management.
• Effective PJI treatment hinges on rapid, accurate diagnostics and collaborative care among general practitioners, orthopedic surgeons, and infectious disease specialists.
• PJI can manifest acutely (peri- or early postoperative) or chronically (late, due to hematogenous seeding), both requiring urgent attention.

Purpose of the Study:

• To provide an overview of the diagnostic and treatment strategies for periprosthetic joint infections (PJI).
• To emphasize the critical role of interdisciplinary collaboration in managing PJI.
• To differentiate treatment approaches for acute versus chronic PJI.

Main Methods:

• Literature review and synthesis of current diagnostic and treatment guidelines for PJI.
• Analysis of treatment outcomes based on infection timing and severity.
• Highlighting the importance of specialized centers for complex PJI cases.

Main Results:

• Acute PJI (< 4 weeks post-implantation or < 3 weeks symptom onset) can often be successfully treated with debridement, antibiotics, and implant retention (DAIR).
• Chronic PJI necessitates a comprehensive interdisciplinary approach, typically involving complete implant exchange and prolonged antibiotic therapy.
• Both surgical intervention and antibiotic therapy must be adequate and coordinated; neither alone is sufficient for cure.

Conclusions:

• Prompt and accurate diagnosis coupled with timely, interdisciplinary treatment is paramount for successful PJI management.
• DAIR is the preferred strategy for acute PJI, while chronic PJI demands more aggressive surgical intervention and tailored antibiotic regimens.
• Referral to specialized centers is essential for optimizing diagnostic and treatment planning in chronic PJI cases.