36 papers, newest 30 shown · updated 2026-09-26 · Adult Reconstruction · All topics
The newest papers on periprosthetic joint infection from the orthopaedic journals The Reduction reads, newest first, each with a one-line summary. The list is drawn from the digest’s archive and refreshed every week.
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Explantation of infected revision TKA components carries high morbidity, with only 35% 10-year survivorship free of reoperation and frequent reinfection, complications, and amputation.
This meta-analysis of 25 studies identifies male sex, obesity, diabetes, smoking, transfusion, high ASA score, and several perioperative factors as associated with periprosthetic joint infection after TKA.
In 1008 total ankle arthroplasties, prosthetic joint infection occurred in 2.7% of cases, with concomitant calcaneal displacement osteotomy raising infection risk nearly 10-fold, though most cases achieved limb salvage with contemporary treatment.
In patients with prior surgically treated PJI in another joint, subsequent primary TJA carried a low 1.5% one-year PJI rate comparable to controls, though prior one/two-stage revision (versus DAIR) and higher comorbidity burden raised risk.
Withholding antibiotics until intraoperative cultures are obtained during PJI resection reduced culture discordance and improved reimplantation success (90% vs 79.6%) compared to giving antibiotics beforehand.
Psoriasis before TKA raises 90-day risk of DVT and wound disruption, and 2-year risk of PJI and revision, so these patients need closer perioperative attention.
Clindamycin-resistant C. acnes isolates produced less acid than susceptible strains, but acid production alone showed only modest diagnostic value for shoulder periprosthetic infection.
In 15 patients treated with cemented modular intramedullary nail knee arthrodesis for chronic PJI, infection control and stability were reliably achieved with good satisfaction, though taller patients and those with more prior surgeries fared worse psychologically.
In 198 PJI cases, failure rates were similarly high (~41-47%) across MSIS-ORT, Delphi, and clinical definitions, but the frameworks disagreed at the individual patient level, showing outcome reporting choice matters.
This review argues that choosing between one- and two-stage exchange for chronic hip PJI should weigh patient treatment burden and institutional protocol capability rather than relying solely on traditional selection criteria, given comparable infection-eradication rates at experienced centers.
This expert review outlines the therapeutic promise of bacteriophage therapy as an adjunct for periprosthetic joint infection while identifying key translational barriers limiting its clinical adoption.
In this 20-year cohort, trauma-related PJI struck earlier and involved different pathogens (more gram-negatives, Enterococcus, Candida; fewer Streptococci) than elective PJI, with higher early mortality but similar cure rates, arguing for tailored perioperative protocols in trauma arthroplasty.
About 14% of revision TKA patients treated for periprosthetic joint infection developed sepsis within 90 days, driven by male sex, renal failure, smoking, obesity, comorbidity burden, and hypoalbuminemia, adding substantial cost.
Single-use surgical gowns are independently associated with increased periprosthetic joint infection rates compared to reusable gowns after hip and knee arthroplasty.
This review highlights emerging mechanisms—like bacterial dormancy, intracellular persistence, and microbiome dysbiosis—that may explain recurrent periprosthetic joint infections despite treatment, suggesting a shift toward infection control rather than eradication.
Single-stage exchange for periprosthetic joint infection costs markedly less than two-stage procedures while achieving comparable infection control when strict surgical criteria are met.
DAIR for acute postoperative periprosthetic joint infection has stable failure rates through 7 weeks; risk accelerates significantly beyond this threshold.
Blood transfusions after revision TKA increase pulmonary embolism, DVT, and periprosthetic infection risks within 90 days.
Next-generation sequencing tools improve detection of organisms and host response in culture-negative periprosthetic joint infections, guiding targeted antimicrobial therapy.
Antibiotic Holiday in 2-Stage Exchange for Periprosthetic Joint Infection: A Scoping Review.
Continuous antibiotic therapy demonstrates lower treatment failure rates than antibiotic holiday during 2-stage exchange for periprosthetic joint infection without requiring extended between-stage intervals.
This review argues that shorter antibiotic courses and earlier oral transition may be as effective as prolonged therapy for periprosthetic joint infection, though evidence quality remains limited.
This AAOS guideline summary provides evidence-based recommendations on dental screening, antibiotic prophylaxis, and procedure timing to prevent periprosthetic joint infection after hip or knee arthroplasty.
Shoulder Periprosthetic Joint Infection: Principles of Prevention, Diagnosis, and Treatment.
This review outlines key principles for preventing, diagnosing, and treating shoulder periprosthetic joint infection, emphasizing its distinct low-virulence organism profile (notably C. acnes) and chronicity-based treatment algorithms.
Optimizing debridement and implant retention in acute periprosthetic joint infections.
This review argues that debridement, antibiotics, and implant retention remains a viable option for acute periprosthetic joint infection, and outlines key factors (timing, staging, team, antibiotics, implant considerations) that optimize DAIR success.
Diagnosis and Management of Periprosthetic Joint Infections After Total Ankle Arthroplasty.
A review outlining risk factors, diagnostic workup, and staged surgical management (debridement, two-stage revision, arthrodesis, amputation) for periprosthetic joint infection after total ankle arthroplasty.
This review outlines an algorithmic approach using serum and synovial markers for diagnosing periprosthetic joint infection across hip, knee, and shoulder, noting shoulder-specific criteria are still lacking.
In 16,500 THAs, direct anterior approach carried higher risk of superficial infection reoperation than posterolateral, but PJI risk was unaffected by approach and driven mainly by BMI.
Local antibiotic delivery (powders, cement, calcium sulphate) in PJI management lacks level-1 evidence and shouldn't replace adherence to established debridement and systemic therapy guidelines.
Antibiotic Spacers for Shoulder Periprosthetic Joint Infection: A Review.
This review contextualizes antibiotic cement spacers for shoulder periprosthetic joint infection, covering their history, types, antibiotic dosing, efficacy, and complications within two-stage revision treatment.
Reviews periprosthetic joint infection after hip hemiarthroplasty, highlighting risk factors, differing microbiology, and the need for multidisciplinary surgical-antibiotic management.
The MSIS workgroup establishes standardized diagnostic criteria for periprosthetic joint infection, combining sinus tract, culture, and lab/histologic thresholds to unify clinical and research definitions.
Economic Burden of Periprosthetic Joint Infection in the United States
US periprosthetic joint infection rates and costs rose sharply from 2001-2009, with projected annual hospital costs exceeding $1.62 billion by 2020, underscoring PJI's growing economic burden.
Periprosthetic Joint Infection: The Incidence, Timing, and Predisposing Factors
In nearly 9,300 primary hip/knee arthroplasties, periprosthetic infection occurred in 0.7% (mostly within the first year), with risk raised by higher ASA score, morbid obesity, bilateral surgery, knee arthroplasty, transfusion, and postoperative complications like UTI or atrial fibrillation.
Proceedings of the International Consensus on Periprosthetic Joint Infection
International consensus on periprosthetic joint infection summarizes current prevention and management practices addressing variation in protocols across orthopedic centers worldwide.
Definition of Periprosthetic Joint Infection
Definition of periprosthetic joint infection.
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