Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Sep;11(3):380-388.
doi: 10.1007/s12178-018-9500-5.

New Innovations in the Treatment of PJI and Biofilms-Clinical and Preclinical Topics

Mariam Taha  1   2 , Hesham Abdelbary  2 , F Patrick Ross  3 , Alberto V Carli  4   5
Affiliations
Review

New Innovations in the Treatment of PJI and Biofilms-Clinical and Preclinical Topics

Mariam Taha et al. Curr Rev Musculoskelet Med. 2018 Sep.

Abstract

Purpose of review: Periprosthetic joint infection (PJI) is a devastating complication after total joint replacement. A main source for antibiotic tolerance and treatment failure is bacterial production of biofilm-a resilient barrier against antibiotics, immune system, and mechanical debridement. The purpose of this review is to explore some novel approaches to treat PJI and biofilm-related infections.

Recent findings: Innovative treatment strategies of bacterial and biofilm infections revolve around (a) augmenting current therapies, such as improving the delivery and efficiency of conventional antibiotics and enhancing the efficacy of antiseptics and (b) administrating completely new therapeutic modalities, such as using immunotherapy, nanoparticles, lytic bacteriophages, photodynamic therapy, novel antibiotics, and antimicrobial peptides. Several promising treatment strategies for PJI are available to be tested further. The next requirement for most of the novel treatments is reproducing their effects in clinically representative animal models of PJI against clinical isolates of relevant bacteria.

Keywords: Antibiotic conjugation; Antimicrobial peptides; Monoclonal antibodies; Nanoparticles; Periprosthetic joint infection; Phage therapy.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest

All authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Fig. 1
Fig. 1
Schematic showing antibiofilm strategies to penetrate, disrupt matrix, and eliminate bacterial cells embedded within the biofilm. These strategies include using lytic phage, nanoparticles (NPs), photodynamic therapy (using laser and phenotiazinic dye), and cathodic voltage-controlled electrical stimulation of titanium
See this image and copyright information in PMC

References

    1. Norman-Taylor FH, Palmer CR, Villar RN. Quality-of-life improvement compared after hip and knee replacement. J Bone Joint Surg Br Vol. 1996;78(1):74. doi: 10.1302/0301-620X.78B1.0780074. - DOI - PubMed
    1. Martinez-Cano JP, Herrera-Escobar JP, Arango Gutierrez AS, Sanchez Vergel A, Martinez-Rondanelli A. Prospective quality of life assessment after hip and knee arthroplasty: short- and mid-term follow-up results. Arthroplast Today. 2017;3(2):125. doi: 10.1016/j.artd.2016.09.008. - DOI - PMC - PubMed
    1. Kapadia BH, Berg RA, Daley JA, Fritz J, Bhave A, Mont MA. Periprosthetic joint infection. Lancet (Lond Engl) 2016;387(10016):386. doi: 10.1016/S0140-6736(14)61798-0. - DOI - PubMed
    1. Berend KR, Lombardi AV, Jr, Morris MJ, Bergeson AG, Adams JB, Sneller MA. Two-stage treatment of hip periprosthetic joint infection is associated with a high rate of infection control but high mortality. Clin Orthop Relat Res. 2013;471(2):510. doi: 10.1007/s11999-012-2595-x. - DOI - PMC - PubMed
    1. Lamagni T. Epidemiology and burden of prosthetic joint infections. J Antimicrob Chemother. 2014;69(Suppl 1):i5. doi: 10.1093/jac/dku247. - DOI - PubMed

LinkOut - more resources