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Bacteriophage therapy, whether used alone or in combination, shows therapeutic potential for treating periprosthetic joint infection after hip and knee arthroplasty.
In the field of orthopedic surgery, periprosthetic joint infection (PJI) following arthroplasty remains one of the most challenging complications, impeding recovery and often leading to prolonged interventions. With antibiotic resistance on the rise, the healthcare community is rapidly seeking more targeted therapeutic options. One such promising solution is bacteriophage therapy that is gaining clinical traction for its ability to fight bacterial infections and disrupt biofilms, all while presenting minimal side effects.
A systematic review by Shengdong Yang et al. examined the potential of bacteriophage therapy as an adjunct treatment for PJI following hip and knee replacements. Researchers conducted an extensive literature search across 7 databases (ClinicalTrials.gov, Cochrane Library, CNKI, Embase PubMed, WanFang, and Web of Science). The review included data from 16 clinical studies (15 case reports and 1 controlled trial) involving 42 patients (average age 62.86 years) treated with bacteriophage therapy.
A total of 43 joints were treated, with volunteers undergoing an average of 5.25 surgeries. Staphylococcus aureus was the most commonly encountered pathogen (reported in 18 cases). Overall, 33 participants received cocktail therapy while 9 participants received a single bacteriophage therapy. After surgery, all the participants also underwent suppressive antibiotic therapy. After an average follow-up of 13.55 months, 2 cases of recurrence were reported, one resulting in amputation.
The remaining participants illustrated good recovery. Thus, bacteriophage therapy effectively eradicated infectious strains with minimal unwanted effects. However, the study authors emphasized that careful preoperative evaluation and the selection of appropriate bacteriophage types are crucial for maximizing therapeutic outcomes. While these results are encouraging, the authors call for large-scale trials to further validate the utility of bacteriophage therapy in this high-risk patient population.
International Orthopaedics
Bacteriophage therapy as an innovative strategy for the treatment of Periprosthetic Joint Infection: a systematic review
Shengdong Yang et al.
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