Evidence
A curated collection of recent peer-reviewed literature on periprosthetic joint infection (PJI) — clinical management, diagnosis and biomarkers, DAIR and revision strategy, and prevention.
20 citations
Core clinical management
Broad, multidisciplinary clinical review covering diagnostic uncertainty, surgical strategy, antimicrobials, and coordination between arthroplasty and infectious-disease teams.
PubMedWide-ranging recent review of prevention, diagnostics, biofilm considerations, and surgical/antimicrobial treatment pathways. Open access.
PubMedUseful strategic overview of global variation in PJI management, burden, resource requirements, and outcomes.
PubMedClinically oriented medical review addressing surgical options—DAIR, one-stage and two-stage revision, resection/arthrodesis/amputation—and antimicrobial induction and suppression strategies.
Article PDFEspecially relevant for recurrent infection and the importance of maximizing success of the index two-stage revision.
PubMedDiagnosis and biomarkers
Practical diagnostic review spanning ESR/CRP, aspiration, synovial analysis, alpha-defensin, imaging, and evolving diagnostic criteria.
PubMedStrong overview of diagnostic frameworks, clinical workup, serum/synovial testing, microbiology, and limitations of individual tests.
PubMedGood reference for emerging serum and synovial biomarkers, including calprotectin and related diagnostic technologies.
PubMedFocused review of radiography, ultrasound, CT, MRI, and nuclear-medicine approaches in suspected PJI.
PubMedEvaluates a synovial-fluid, multi-biomarker probability score integrating inflammatory, specimen-integrity, alpha-defensin, and microbial-antigen markers; reported sensitivity and specificity were 99.3% and 99.5% versus its clinical reference standard before reclassification of inconclusive cases.
PubMedReview of investigational and emerging detection methods, including implantable pH sensors, X-ray-excited luminescence chemical imaging, urinary peptide biomarkers, molecular profiling, and rapid synovial assays.
PubMedDAIR and revision strategy
Key recent DAIR evidence synthesis for early postoperative and acute hematogenous PJI. Across included cohorts, reported success ranged from 55.5% to 90%, with a mean of 71%; it also highlights the shortage of randomized comparative trials against revision strategies.
PubMedContemporary outcomes study reporting approximately 19% reoperation by two years after DAIR, useful for setting expectations and framing risk-stratified patient selection.
PubMedRecent review of the expanding role of one-stage exchange in carefully selected PJI patients, including its potential clinical and economic advantages relative to traditional two-stage management.
PubMedTKA-specific review that is useful for comparing indications, selection criteria, and evidence for one-stage versus two-stage exchange.
PubMedActionable surgical-process paper identifying dual surgical setup as a potentially modifiable factor associated with lower recurrence after two-stage exchange of hip or knee PJI.
PubMedPrevention, antibiotics, and care models
Timely antimicrobial-duration review. It discusses shorter systemic courses, early oral transition, biofilm-active regimens, DAIR duration, and the role of antibiotic-loaded spacers.
PubMedPrevention-focused review addressing modifiable risk factors, microbiologic screening, optimization, and multidisciplinary preoperative pathways in knee arthroplasty.
Full textTwo especially useful additions
Compares 2018 with 2025 ICM recommendations. The analysis identified substantive changes in 37 of 172 comparable questions and describes more directive 2025 recommendations, including updated DAIR antibiotic-duration guidance and repeat-DAIR considerations.
AbstractParticularly relevant for value dossiers, resource planning, investor materials, and market-access discussions; it stratifies economic considerations by DAIR, one-stage exchange, and two-stage revision.
PubMed