{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:31:24Z","timestamp":1787027484645,"version":"build-2736575974"},"reference-count":74,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Periprosthetic joint infection (PJI) remains one of the most severe and complex complications following joint arthroplasty. With the global increase in primary hip and knee replacements, the clinical and economic burden associated with PJI continues to grow. Although relatively uncommon, PJI is linked to substantial morbidity, elevated mortality, and significantly higher healthcare costs compared to aseptic revision procedures. The challenge is compounded by the intricate pathogenesis of biofilm-forming microorganisms, heterogeneous clinical presentations, and the lack of universally standardised diagnostic criteria. This review provides an integrated overview of current evidence concerning the pathophysiology, risk factors, and microbiological patterns associated with PJI. Contemporary diagnostic pathways based on the Musculoskeletal Infection Society\/International Consensus Meeting (MSIS\/ICM) criteria are summarised, including the utility and limitations of established serological markers, emerging synovial biomarkers such as alpha-defensin, and the complementary roles of culture techniques, histopathology, and molecular assays. Medical and surgical treatment strategies are outlined, including debridement with implant retention, one-stage and two-stage revision approaches, and organism-directed antimicrobial therapy. Preventive strategies spanning preoperative optimisation, intraoperative protocols, and postoperative risk reduction are also highlighted. Despite significant advances, important gaps persist, particularly in antimicrobial resistance, the management of polymicrobial or culture-negative infections, and the treatment of high-risk or immunocompromised patients. Continued interdisciplinary collaboration and high-quality clinical research are essential to refine diagnostic algorithms, improve therapeutic outcomes, and reduce the incidence of this increasingly consequential complication.<\/jats:p>","DOI":"10.3390\/antibiotics15060614","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T08:22:56Z","timestamp":1781684576000},"page":"614","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of Periprosthetic Joint Infections: A Multidisciplinary Approach"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9045-9493","authenticated-orcid":false,"given":"Madhan","family":"Jeyaraman","sequence":"first","affiliation":[{"name":"Department of Regenerative Medicine, Agathisha Institute of Stem Cell and Regenerative Medicine (AISRM), Chennai 600030, Tamil Nadu, India"},{"name":"Department of Orthopaedics, Dr. MGR Educational and Research Institute, ACS Medical College and Hospital, Chennai 600077, Tamil Nadu, India"},{"name":"Orthopaedic Research Group, Department of Orthopaedics, Coimbatore 641045, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Migliorini","sequence":"additional","affiliation":[{"name":"Department of Trauma and Reconstructive Surgery, University Hospital of Halle, Martin-Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany"},{"name":"Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, Kammerbruchstr. 8, 52152 Simmerath, Germany"},{"name":"Department of Life Sciences, Health, and Health Professions, Link Campus University, Via del Casale di San Pio V, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luise","family":"Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Department of Trauma and Reconstructive Surgery, University Hospital of Halle, Martin-Luther University Halle-Wittenberg, 06097 Halle (Saale), Germany"},{"name":"Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, Kammerbruchstr. 8, 52152 Simmerath, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4362-3326","authenticated-orcid":false,"given":"Naveen","family":"Jeyaraman","sequence":"additional","affiliation":[{"name":"Department of Regenerative Medicine, Agathisha Institute of Stem Cell and Regenerative Medicine (AISRM), Chennai 600030, Tamil Nadu, India"},{"name":"Department of Orthopaedics, Dr. MGR Educational and Research Institute, ACS Medical College and Hospital, Chennai 600077, Tamil Nadu, India"},{"name":"Orthopaedic Research Group, Department of Orthopaedics, Coimbatore 641045, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1308\/rcsann.2021.0206","article-title":"Projections for primary hip and knee replacement surgery up to the year 2060: An analysis based on data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man","volume":"104","author":"Matharu","year":"2022","journal-title":"Ann. 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