Infection in Joint Arthroplasty: Diagnosis, Prevention, and Treatment Strategies-A Comprehensive Narrative Review

Periprosthetic joint infection (PJI) remains one of the most severe complications after total joint arthroplasty, causing significant morbidity and healthcare burden. Despite advances in surgical techniques, diagnostics, and antimicrobial therapy, infection rates have not declined substantially, emphasizing the need for comprehensive preventive and therapeutic strategies.

This narrative review synthesizes evidence from peer-reviewed clinical studies, consensus statements, and major international guidelines addressing periprosthetic joint infection in hip, knee, and shoulder arthroplasty.

Recent evidence highlights advances in diagnostic biomarkers, molecular testing, and standardized consensus criteria that have improved early detection. Surgical strategies such as DAIR, one-stage, and two-stage revisions-combined with biofilm-active antimicrobial therapy-remain the mainstay of management. Preventive measures focusing on perioperative optimization, infection control, and antibiotic stewardship are the most effective means to reduce infection risk.

Future progress relies on precision-based prevention, novel biofilm-targeted therapies, and multidisciplinary collaboration to achieve durable, infection-free outcomes following joint arthroplasty.