[Bacteriophage Therapy in Orthopaedics and Trauma]

Area of Science:

• Orthopedics
• Infectious Diseases
• Microbiology

Background:

• Orthopedic infections like fracture-related infection (FRI) and periprosthetic joint infection (PJI) are challenging due to biofilms, multidrug-resistant pathogens, and poor outcomes.
• Current treatments often involve repeated surgeries and prolonged antibiotic use, highlighting the need for novel strategies.

Purpose of the Study:

• To evaluate bacteriophage therapy as a potential adjunctive treatment for orthopedic and trauma-related infections.
• To explore the rationale, experimental evidence, and current clinical standing of bacteriophages in managing FRI and PJI.

Main Methods:

• Review of experimental studies demonstrating bacteriophage efficacy against bacterial burden and biofilms.
• Analysis of progress in local delivery systems and diagnostics for personalized phage therapy.
• Assessment of existing clinical evidence, primarily from case reports and small series.

Main Results:

• Bacteriophages exhibit high specificity, replicate at infection sites, and show activity against biofilms.
• Experimental studies indicate reduced bacterial load, biofilm disruption, and enhanced phage-antibiotic combination efficacy.
• Progress in delivery systems and diagnostics supports personalized phage-based approaches.

Conclusions:

• Bacteriophage therapy is a promising adjunctive strategy for orthopedic infections, particularly FRI and PJI.
• Current clinical evidence is limited, with preliminary results from case reports and small series.
• Bacteriophage therapy is currently an individualized adjunctive option, not yet a standard of care for FRI and PJI.