Managing the Challenge of Periprosthetic Joint Infection

Dear Colleagues,

Periprosthetic joint infection (PJI) remains one of the most challenging complications after arthroplasty, with substantial patient morbidity, health-system burden, and complex decision-making across diagnostics and treatment.

Despite advances in microbiology, imaging, and surgical techniques, we still face critical gaps: early and reliable diagnosis in culture-negative or low-grade infections; optimal use of molecular assays and sonication; choosing between DAIR, one-stage, and two-stage strategies; antibiotic duration and combinations in the era of AMR; and standardized outcome reporting that meaningfully reflects infection control, function, and quality of life.

This Special Issue of Prosthesis focuses on contemporary, pragmatic solutions for the diagnosis and treatment of PJI, bridging orthopedic surgery and infectious diseases. We welcome studies that inform day-to-day clinical choices and implementation: comparative effectiveness across surgical strategies; diagnostic accuracy of novel tests; antimicrobial optimization (including long-acting agents); multidisciplinary pathways; real-world outcomes. Methodological rigor (prospective cohorts, registries, meta-research, consensus methods) and transparent reporting are strongly encouraged.

Suggested themes:

• Diagnostic standards and innovations: biomarkers, next-generation sequencing, metagenomics, PCR/NGS panels, sonication, imaging, and composite criteria;
• Surgical strategies: DAIR optimization; one- vs. two-stage revision; spacer concepts; megaprostheses; salvage procedures;
• Antimicrobial therapy: IV-to-oral switch, long-acting lipoglycopeptides, anti-biofilm combinations, dosing/PK-PD in bone and biofilm, and OPAT models;
• Difficult pathogens and hosts: MRSA/MRSE, rifampicin resistance, Gram-negative and polymicrobial PJI, fungal PJI, culture-negative PJI, and immunocompromised hosts.
• Prevention and risk reduction: decolonization, perioperative prophylaxis in AMR settings, laminar flow/OR practices, and host optimization;
• Outcomes and methodology: core outcome sets, failure definitions, competing-risk analysis, cost-effectiveness, and patient-reported outcomes;
• Consensus and pathways: ID–orthopedics co-management, multidisciplinary boards, protocolized care, and registry-based quality improvement.

For this Special Issue, we invite original research, reviews, short communications, technical notes, and consensus statements, as well as case-reports. We look forward to receiving your contributions.

Dr. Rareş Mircea Bîrluţiu
Dr. Jaime Esteban
Dr. Efthymia Giannitsioti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Prosthesis is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.