{
    "abstract": "as the demand for total joint arthroplasty continues to grow each year, the healthcare burden is expected to increase due to periprosthetic joint infection (PJI). This review article aims to highlight the significance of biofilms in the pathogenesis of PJI and introduce alternative therapies that prevent bacterial adhesion to implants or enhance their eradication when infection occurs.\nwe conducted a bibliographic search in PubMed using the following MeSH terms as follows: \"no antibiotic treatment of PJI\", \"bacterial biofilm eradication agents\", and \"unconventional prevention of PJI\", among others. Most important results: after an initial analysis of the literature, we selected the most significant topics on novel PJI treatment methods and prevention strategies. A second PubMed search highlighted the following therapeutic modalities: the application of hydrogels on implant surfaces, the use of phage therapy, lysostaphin and antimicrobial peptides, the implementation of two-stage debridement, irrigation, implant retention and antibiotic therapy (DAIR), the intra-articular antibiotic infusion, and the use of methylene blue for biofilm eradication.\nthe use of new cement spacers with xylitol, ammonium compounds, or silver nanoparticles is another promising technique to increase the eradication rate in two-stage revision. It is important for professionals to deeply understand the pathogenesis of PJI and the role of biofilms in its development in order to become familiar with these novel techniques that could reduce the burdens on healthcare systems.",
    "authors": [
        {
            "affiliation": "'Sir John Charnley' Hip Surgery Unit, Institute of Orthopaedics 'Carlos E. Ottolenghi', Italian Hospital of Buenos Aires, 4190 Per\u00f3n St., Buenos Aires C1199ABH, Argentina.\nInstitute of Medical and Health Sciences Research (IIMCS), Faculty of Medicine, Salvador University, 1601 C\u00f3rdoba Av., Buenos Aires C1055AAG, Argentina.",
            "firstname": "Daniyil",
            "initials": "D",
            "lastname": "Semeshchenko"
        },
        {
            "affiliation": "'Sir John Charnley' Hip Surgery Unit, Institute of Orthopaedics 'Carlos E. Ottolenghi', Italian Hospital of Buenos Aires, 4190 Per\u00f3n St., Buenos Aires C1199ABH, Argentina.",
            "firstname": "Pablo A",
            "initials": "PA",
            "lastname": "Slullitel"
        },
        {
            "affiliation": "Institute of Medical and Health Sciences Research (IIMCS), Faculty of Medicine, Salvador University, 1601 C\u00f3rdoba Av., Buenos Aires C1055AAG, Argentina.",
            "firstname": "Alicia",
            "initials": "A",
            "lastname": "Farinati"
        },
        {
            "affiliation": "'Sir John Charnley' Hip Surgery Unit, Institute of Orthopaedics 'Carlos E. Ottolenghi', Italian Hospital of Buenos Aires, 4190 Per\u00f3n St., Buenos Aires C1199ABH, Argentina.",
            "firstname": "Agustin F",
            "initials": "AF",
            "lastname": "Albani-Forneris"
        },
        {
            "affiliation": "Department of Orthopaedic Surgery Cleveland, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.",
            "firstname": "Nicolas S",
            "initials": "NS",
            "lastname": "Piuzzi"
        },
        {
            "affiliation": "'Sir John Charnley' Hip Surgery Unit, Institute of Orthopaedics 'Carlos E. Ottolenghi', Italian Hospital of Buenos Aires, 4190 Per\u00f3n St., Buenos Aires C1199ABH, Argentina.",
            "firstname": "Martin A",
            "initials": "MA",
            "lastname": "Buttaro"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.3390/jcm14082610\n10.2106/00004623-200704000-00012\n10.1016/j.arth.2020.12.005\n10.1302/2058-5241.3.170032\n10.1002/jor.24293\n10.1016/j.jdsr.2021.05.003\n10.1186/s12575-019-0106-0\n10.3389/fcimb.2022.896978\n10.1128/AAC.31.6.889\n10.1111/1469-0691.12651\n10.3390/antibiotics10101270\n10.1186/s13018-015-0294-5\n10.1302/0301-620X.97B2.34554\n10.1186/s12891-017-1742-7\n10.1016/j.injury.2016.07.054\n10.1155/2016/9079041\n10.1016/j.jor.2024.10.009\n10.1302/0301-620X.95B7.31124\n10.1097/CORR.0000000000001753\n10.1007/s00776-012-0247-3\n10.1007/s11999-014-3558-1\n10.1007/s00264-013-2237-2\n10.1007/s10195-017-0442-2\n10.1021/acsabm.2c01083\n10.1016/j.arth.2024.02.044\n10.1016/j.arth.2019.02.013\n10.1007/s11999-010-1293-9\n10.1016/j.arth.2022.02.040\n10.1016/j.jinf.2019.07.003\n10.1016/j.arth.2017.03.010\n10.1016/j.arth.2017.07.019\n10.1007/s11999-010-1313-9\n10.1007/s00402-024-05341-2\n10.1007/s00402-023-04891-1\n10.5194/jbji-6-91-2021\n10.2106/JBJS.OA.19.00062\n10.1016/j.arth.2010.01.104\n10.1016/j.jinf.2018.07.014\n10.1302/0301-620X.105B3.BJJ-2022-0926.R1\n10.4103/0019-5413.106925\n10.1186/s12891-021-04451-x\n10.3928/01477447-20210414-12\n10.1302/0301-620X.104B7.BJJ-2021-1704.R1\n10.1016/j.knee.2011.07.012\n10.1098/rsob.210188\n10.7759/cureus.70414\n10.1002/jor.25432\n10.1186/s40634-023-00586-z\n10.3389/fmicb.2023.1250848\n10.3390/antibiotics12061044\n10.3390/v5010015\n10.1016/j.heliyon.2024.e34333\n10.2106/JBJS.K.01135\n10.1111/j.1574-695X.2012.00977.x\n10.1371/journal.pone.0157626\n10.3390/v15020499\n10.1093/cid/ciac694\n10.3389/fmed.2020.00342\n10.1556/1886.2024.00010\n10.1126/sciadv.aaw1228\n10.1371/journal.pone.0113797\n10.1111/jam.14985\n10.3390/antibiotics11101417\n10.1016/j.lfs.2020.118407\n10.3390/ph11010020\n10.1007/s00402-020-03694-y\n10.1021/acsami.1c19834\n10.1039/C8RA00750K\n10.1016/j.drudis.2009.10.009\n10.1016/j.progpolymsci.2017.03.001\n10.1016/j.mtbio.2023.100586\n10.1016/j.jot.2013.06.002\n10.1128/AAC.03489-14\n10.1039/C5RA07540H\n10.3390/ma14123413\n10.1016/j.jor.2024.02.008\n10.3390/ma13153258\n10.1002/jor.24074\n10.1002/jor.23903\n10.3390/antibiotics10030270\n10.5194/jbji-6-119-2021\n10.1016/j.jisako.2022.08.002\n10.1177/1120700020929314\n10.3390/diagnostics12051207\n10.5194/jbji-6-283-2021\n10.1302/0301-620X.104B9.BJJ-2022-0396.R1\n10.7150/jbji.31592\n10.7759/cureus.60390\n10.1016/j.arth.2017.03.051\n10.1016/j.artd.2022.01.023\n10.3390/gels9090758",
    "journal": "Journal of clinical medicine",
    "keywords": [
        "biofilm",
        "infection prevention",
        "new strategies",
        "periprosthetic joint infection",
        "unconventional treatment"
    ],
    "methods": null,
    "publication_date": "2025-04-26",
    "pubmed_id": "40283439\n17403800\n33422392\n30233819\n30977537\n31850313\n34188729\n31528123\n35846761\n3619420\n24766583\n34680850\n26429342\n25628291\n28865425\n27568843\n27642605\n39563860\n23814255\n33847603\n22806173\n24622801\n24363076\n28155060\n36867723\n38401619\n30872035\n20224958\n35189287\n31319141\n28420544\n28811108\n20390472\n38691147\n37101087\n34084696\n33123664\n20378306\n30092305\n36854321\n23533105\n34144684\n34039203\n35775176\n21880493\n34520699\n36225325\n39473661\n36031587\n36786898\n37869667\n37370363\n23344559\n39100447\n23324958\n22524448\n27333300\n36851713\n36104853\n32850878\n38436674\n31114804\n25464506\n33382154\n36290075\n32931796\n29462909\n33386976\n34886671\n35539499\n19879957\n32287485\n36896412\n25070107\n34203010\n22242097\n38435311\n32707995\n29924414\n29603341\n33800299\n34084700\n35973626\n32907425\n35626362\n34345576\n36047024\n31011512\n38883114\n28434697\n35252512\n37754439\n26330591",
    "results": null,
    "title": "Unconventional Therapies in Periprosthetic Joint Infections: Prevention and Treatment: A Narrative Review.",
    "xml": "<Element 'PubmedArticle' at 0x788506c62930>"
}