Articles | Volume 10, issue 2
https://doi.org/10.5194/jbji-10-85-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-10-85-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
The hidden connection between gut microbiota and periprosthetic joint infections: a scoping review
Alessandro Singlitico
Department of Orthopaedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Daniele Grassa
Department of Orthopaedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Rami Kaplan
Department of Orthopaedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Alessandro Smimmo
Department of Orthopaedic and Traumatology, Aurelia Hospital Garofalo Healthcare, 00165 Rome, Italy
Giulio Maccauro
Department of Orthopaedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Raffaele Vitiello
CORRESPONDING AUTHOR
Department of Orthopaedics, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Guido Bocchino, Giulio Maccauro, Andrea Zampoli, Rocco Papalia, Pier Francesco Indelli, Daniel Pérez-Prieto, and Javad Parvizi
J. Bone Joint Infect., 11, 479–488, https://doi.org/10.5194/jbji-11-479-2026, https://doi.org/10.5194/jbji-11-479-2026, 2026
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The current umbrella review showed that prevalence, diagnostic performance of adjunctive molecular methods, treatment strategies, and outcomes vary substantially. Molecular diagnostics appear to be promising as adjunctive tools in selected cases, but their interpretation requires caution, and they do not resolve all uncertainties related to culture-negative periprosthetic joint infections.
Doriana Di Costa, Giacomo Capece, Donato Coppola, Elena Matteini, Pierluigi Del Vecchio, Francesco Taccari, Giuseppe Maccagnano, Carlo Torti, Giulio Maccauro, and Raffaele Vitiello
J. Bone Joint Infect., 11, 277–285, https://doi.org/10.5194/jbji-11-277-2026, https://doi.org/10.5194/jbji-11-277-2026, 2026
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This systematic review evaluates debridement, antibiotic pearls and implant retention (DAPR) as a treatment option for acute periprosthetic joint infection. Analysis of available clinical studies shows encouraging infection control rates with few complications, suggesting that this approach may help to preserve implants in selected patients. However, current evidence is limited, and larger well-designed studies are needed to confirm its effectiveness and clarify its role in clinical practice.
Domenico De Mauro, Chiara Comisi, Valeria Maccauro, Giovanni Balato, Sebastian Meller, Martina Di Martino, Fabiana Arduini, Giulio Maccauro, and Raffaele Vitiello
J. Bone Joint Infect., 11, 139–147, https://doi.org/10.5194/jbji-11-139-2026, https://doi.org/10.5194/jbji-11-139-2026, 2026
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This retrospective study analyzed 682 patients who underwent primary total hip or knee arthroplasty to evaluate the impact of malnutrition on post-operative outcomes. Malnutrition, as defined by the Nutritional Risk Screening 2002 (NRS-2002) and controlling nutritional status (CONUT) scores, was significantly associated with higher rates of post-operative infection and poorer quality-of-life scores. Early nutritional assessment may improve post-operative recovery and reduce complication rates.
Domenico De Mauro, Cesare Meschini, Giovanni Balato, Tiziana Ascione, Enrico Festa, Davide Bizzoca, Biagio Moretti, Giulio Maccauro, and Raffaele Vitiello
J. Bone Joint Infect., 9, 137–142, https://doi.org/10.5194/jbji-9-137-2024, https://doi.org/10.5194/jbji-9-137-2024, 2024
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This study investigates sex-related differences in periprosthetic Joint Infections (PJIs) after total joint arthroplasty. A systematic review of nine studies reveals a higher risk of infectious complications in males compared to females, as indicated by statistically significant findings in half of the studies. This underscores the need for ongoing sex-related analysis to enhance evidence and insights in the field of PJIs.
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Short summary
In this article we discuss how gut microbiota can affect the outcomes of a total joint arthroplasty. Total joint arthroplasty is a safe procedure for improving the quality of life in patients affected by arthrosis. Periprosthetic joint infection (PJI) is relatively rare but represents one of the most common causes of implant failure requiring revision surgery. Recently, there has been a major interest in the role of gut microbiome, in particular dysbiosis, as a risk factor for PJI.
In this article we discuss how gut microbiota can affect the outcomes of a total joint...