Semeshchenko Daniyil, Slullitel Pablo A, Farinati Alicia, Albani-Forneris Agustin F, Piuzzi Nicolas S, Buttaro Martin A
'Sir John Charnley' Hip Surgery Unit, Institute of Orthopaedics 'Carlos E. Ottolenghi', Italian Hospital of Buenos Aires, 4190 Perón St., Buenos Aires C1199ABH, Argentina.
Institute of Medical and Health Sciences Research (IIMCS), Faculty of Medicine, Salvador University, 1601 Córdoba Av., Buenos Aires C1055AAG, Argentina.
J Clin Med. 2025 Apr 10;14(8):2610. doi: 10.3390/jcm14082610.
as the demand for total joint arthroplasty continues to grow each year, the healthcare burden is expected to increase due to periprosthetic joint infection (PJI). This review article aims to highlight the significance of biofilms in the pathogenesis of PJI and introduce alternative therapies that prevent bacterial adhesion to implants or enhance their eradication when infection occurs.
we conducted a bibliographic search in PubMed using the following MeSH terms as follows: "no antibiotic treatment of PJI", "bacterial biofilm eradication agents", and "unconventional prevention of PJI", among others. Most important results: after an initial analysis of the literature, we selected the most significant topics on novel PJI treatment methods and prevention strategies. A second PubMed search highlighted the following therapeutic modalities: the application of hydrogels on implant surfaces, the use of phage therapy, lysostaphin and antimicrobial peptides, the implementation of two-stage debridement, irrigation, implant retention and antibiotic therapy (DAIR), the intra-articular antibiotic infusion, and the use of methylene blue for biofilm eradication.
the use of new cement spacers with xylitol, ammonium compounds, or silver nanoparticles is another promising technique to increase the eradication rate in two-stage revision. It is important for professionals to deeply understand the pathogenesis of PJI and the role of biofilms in its development in order to become familiar with these novel techniques that could reduce the burdens on healthcare systems.
随着全关节置换术的需求逐年持续增长，由于假体周围关节感染（PJI），医疗负担预计会增加。这篇综述文章旨在强调生物膜在PJI发病机制中的重要性，并介绍在感染发生时可防止细菌粘附于植入物或增强其根除效果的替代疗法。
我们在PubMed中使用以下医学主题词进行文献检索：“PJI的非抗生素治疗”、“细菌生物膜根除剂”、“PJI的非常规预防”等。最重要的结果：在对文献进行初步分析后，我们选择了关于新型PJI治疗方法和预防策略的最重要主题。第二次PubMed检索突出了以下治疗方式：在植入物表面应用水凝胶、使用噬菌体疗法、溶葡萄球菌酶和抗菌肽、实施两阶段清创、冲洗、保留植入物和抗生素治疗（DAIR）、关节内抗生素输注以及使用亚甲蓝根除生物膜。
使用含有木糖醇、铵化合物或银纳米颗粒的新型骨水泥间隔物是另一种有前景的技术，可提高两阶段翻修的根除率。专业人员深入了解PJI的发病机制以及生物膜在其发展中的作用非常重要，以便熟悉这些可减轻医疗系统负担的新技术。
