Novel Methods for Prevention and Treatment of Periprosthetic Joint Infections

Dear Colleagues,

Periprosthetic joint infection (PJI) is the most common cause of failure of total joint arthroplasty and results in a significant reduction in quality of life when compared to the general population. Additionally, the cost to the health system is burdensome and frequently increases morbidity and especially mortality of patients within 5 years. To deal with this complication, several preventative and treatment methods have been recommended. Preventative approaches range from preoperative (patient optimization, antibiotic prophylaxis, skin cleansing) and intraoperative (proper sealing and draping of skin, meticulous surgical site preparation, wound irrigation, management of surgical theater environment) to postoperative ones (blood preservation). Additionally, there is novel evidence related to perioperative management of medications, controlling operating room traffic air flow, and choice of wound dressing or vacuum-assisted devices. For treatment of PJI, two-stage arthroplasty is the present gold standard surgical procedure in the US. However, new evidence supports the use of one-stage arthroplasty in selective PJI cases, and research is still underway. While many preventative and treatment protocols are in place, there are voids in the literature. Additionally, such strategies may different in knees, hips, and shoulder arthroplasties. As a result, further research is encouraged to practice evidence-based medicine. In the current focused Special Issue, we intend to describe the utility of novel preventative and treatment strategies in the setting of PJI.

Dr. Carlos A. Higuera
Guest Editor

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