Current aspects of periprosthetic joint infection treatment : a literature review

   Introduction: Periprosthetic joint infection (PJI) remains one of the most serious complications following total joint arthroplasty, with an incidence of up to 2 % after primary and 4–6 % after revision procedures. Increasing antimicrobial resistance and the complexity of treatment necessitate continuous refinement of diagnostic and therapeutic strategies.

   Aim. To provide a comprehensive review of current diagnostic methods and treatment approaches for PJI, with a particular focus on recent spacer innovations. This article is the first Russian-language review to systematize up-to-date global data and technological advances in the field.

   Materials and Methods. A systematic search was conducted in PubMed, eLIBRARY, and Google Scholar databases, focusing on publications from the past 10 years. Inclusion criteria followed the PRISMA protocol. Forty-seven articles, including clinical studies, meta-analyses, and reviews, were analyzed.

   Results and discussion. Coagulase-negative staphylococci and Staphylococcus aureus remain the most frequent pathogens, often protected by biofilms. Diagnostic criteria from MSIS and ICM include biomarkers (e. g., alpha-defensin), leukocyte esterase, and synovial fluid analysis. Two-stage revision arthroplasty with antibiotic-loaded cement spacers remains the standard of care. The review highlights novel spacer modifications, including personalized 3D-printed designs, embedded drug reservoirs, and magnetically controlled delivery systems. The potential role of bacteriophage therapy in multidrug-resistant infections is also discussed.

   Conclusion. This review consolidates current knowledge and recent innovations in PJI diagnosis and treatment, addressing a gap in Russian-language literature. The integration of advanced materials, technologies, and diagnostic tools represents a promising direction for improving patient outcomes

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