Synchronous Periprosthetic Joint Infections: A Scoping Review of the Literature

Area of Science:

• Orthopedic surgery
• Infectious diseases
• Rheumatology

Background:

• Synchronous prosthetic joint infections (PJIs) affecting multiple joints simultaneously are exceptionally rare.
• These infections are often linked to bacteremia and carry high mortality rates.
• Identifying risk factors is crucial for early detection and management.

Purpose of the Study:

• To review the current understanding of synchronous PJIs.
• To identify associated risk factors and discuss diagnostic considerations.
• To explore treatment options and highlight areas for future research.

Main Methods:

• Literature review of synchronous PJI cases.
• Analysis of reported risk factors including rheumatoid arthritis, neoplasia, and immunosuppressive therapy.
• Discussion of diagnostic approaches and treatment modalities, including one-stage vs. two-stage exchange.

Main Results:

• Recurring risk factors for synchronous PJI include multiple prosthetic joints, rheumatoid arthritis, neoplasia, bacteremia, and immune-modulating therapy.
• A high index of suspicion is warranted, considering all prosthetic joints potentially infected.
• One-stage exchange may offer advantages over two-stage protocols by reducing surgical procedures.

Conclusions:

• Synchronous PJI is a severe complication requiring prompt investigation of all prosthetic joints.
• Treatment decisions must be individualized, with one-stage exchange showing potential benefits.
• More research is essential to establish definitive diagnostic and therapeutic guidelines for synchronous PJI.