Global Perspectives on the Management of Periprosthetic Joint Infection

➢ The rate of periprosthetic joint infection (PJI) is rising globally, with substantial regional variability, and PJI has 5-year mortality rates of 15% to 25%, which exceed those of early-stage breast and prostate cancer and rival those of colorectal and hematologic malignancies. ➢ Diagnostic criteria, including synovial fluid analysis, novel culture techniques, and molecular techniques, have improved in accuracy. However, infections caused by fastidious, biofilm-forming microorganisms continue to pose a major diagnostic challenge worldwide. ➢ While patient selection remains critical for successful outcomes, the use of DAIR (debridement, antibiotics, and implant retention), 1-stage, 2-stage, and 1.5-stage procedures varies across regions and is often influenced by logistical constraints, resource availability, and clinical expertise. In parallel, discordant definitions of treatment success in the literature hinder comparative research and outcome benchmarking. A tiered framework—encompassing infection eradication, surgical burden, joint function, and patient-reported outcomes—offers a path toward standardized and clinically meaningful reporting. ➢ Advances in immunogenetics, artificial intelligence-driven risk modeling, and precision medicine, alongside the emergence of research consortia and global collaborations, are opening new frontiers in treatment strategies and creating opportunities for innovative, individualized approaches to PJI management.