Candida Periprosthetic Joint Infection: Is It Curable?

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Mycology

Background:

• Candida periprosthetic joint infection (CPJI) is a rare but severe complication following joint replacement surgery.
• Candida species form biofilms on medical devices, leading to persistent and recurrent infections.
• Current management guidelines lack high-quality evidence, particularly regarding optimal antifungal treatment and duration.

Purpose of the Study:

• To review the current understanding and management strategies for Candida periprosthetic joint infection (CPJI).
• To highlight the challenges in treating CPJI due to biofilm formation and patient factors.
• To discuss the controversial aspects of antifungal-loaded cement spacers and identify areas for future research.

Main Methods:

• Retrospective case series analysis.
• Review of existing literature on Candida periprosthetic joint infection management.
• Discussion of surgical and antifungal treatment options.

Main Results:

• Two-stage exchange surgery shows higher success rates in managing CPJI.
• Optimal antifungal treatment regimens and durations are not clearly defined.
• The efficacy of antifungal-loaded cement spacers remains controversial.

Conclusions:

• Effective management of CPJI requires a multidisciplinary approach.
• Further high-quality research is needed to establish evidence-based treatment protocols.
• Prevention and early identification of at-risk patients are crucial for improving outcomes.