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<p>Prosthetic joint infection (PJI) is a serious complication of arthroplasty, leading to significant morbidity, extended hospital stays, and high healthcare costs. This review provides an update on the prevention, diagnosis, and management of hip PJIs in 2025. Preventive measures, including patient optimization, antibiotic prophylaxis, improved surgical techniques, and innovative biomaterials, show promise but require further validation through clinical trials. Diagnostic advancements, such as next-generation sequencing and novel biomarkers, are enhancing diagnostic speed and accuracy. Tools like the Musculoskeletal Infection Society (MSIS) criteria, incorporating laboratory markers (CRP, ESR) and synovial biomarkers (alpha-defensin, leukocyte esterase), remain standard due to the inclusion of a wide array of tests undertaken in a stepwise manner in the preoperative and intraoperative period. However, this process can be tedious, and challenges related to cost, accessibility, and the need for multidisciplinary expertise remain. Management strategies are individualized, ranging from debridement, antibiotics, and implant retention (DAIR) to single- or two-stage revisions, tailored to infection chronicity, patient health, and microbial factors. Local antibiotic delivery systems, such as antibiotic-loaded spacers and coatings, augment systemic therapy. Emerging approaches, including biofilm disruption therapies, microbiome modulation, and genetic risk stratification, offer potential breakthroughs. Despite these advances, the incidence of PJI is projected to rise due to the growing number of arthroplasty procedures globally. Addressing this challenge necessitates a multidisciplinary, evidence-based approach encompassing enhanced preventive strategies, advanced diagnostics, and personalized treatment protocols. The integration of emerging technologies and translational research into clinical practice will be critical to reducing the burden of PJIs and improving patient outcomes. This review underscores the importance of continued innovation, collaboration, and rigorous clinical evaluation to advance the field, ensuring that care for patients with hip PJIs remains at the forefront of orthopedic excellence.</p>

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Prosthetic Joint Infection of the Hip: Mitigation and Management in 2025

  • 期刊论文

  • 发表日期：

    2026年4月11日

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  • Apoorva Kabra,
  • Vivek Shankar,
  • Benu Dhawan,
  • Vijay Kumar

摘要

Prosthetic joint infection (PJI) is a serious complication of arthroplasty, leading to significant morbidity, extended hospital stays, and high healthcare costs. This review provides an update on the prevention, diagnosis, and management of hip PJIs in 2025. Preventive measures, including patient optimization, antibiotic prophylaxis, improved surgical techniques, and innovative biomaterials, show promise but require further validation through clinical trials. Diagnostic advancements, such as next-generation sequencing and novel biomarkers, are enhancing diagnostic speed and accuracy. Tools like the Musculoskeletal Infection Society (MSIS) criteria, incorporating laboratory markers (CRP, ESR) and synovial biomarkers (alpha-defensin, leukocyte esterase), remain standard due to the inclusion of a wide array of tests undertaken in a stepwise manner in the preoperative and intraoperative period. However, this process can be tedious, and challenges related to cost, accessibility, and the need for multidisciplinary expertise remain. Management strategies are individualized, ranging from debridement, antibiotics, and implant retention (DAIR) to single- or two-stage revisions, tailored to infection chronicity, patient health, and microbial factors. Local antibiotic delivery systems, such as antibiotic-loaded spacers and coatings, augment systemic therapy. Emerging approaches, including biofilm disruption therapies, microbiome modulation, and genetic risk stratification, offer potential breakthroughs. Despite these advances, the incidence of PJI is projected to rise due to the growing number of arthroplasty procedures globally. Addressing this challenge necessitates a multidisciplinary, evidence-based approach encompassing enhanced preventive strategies, advanced diagnostics, and personalized treatment protocols. The integration of emerging technologies and translational research into clinical practice will be critical to reducing the burden of PJIs and improving patient outcomes. This review underscores the importance of continued innovation, collaboration, and rigorous clinical evaluation to advance the field, ensuring that care for patients with hip PJIs remains at the forefront of orthopedic excellence.