Articles | Volume 11, issue 3
https://doi.org/10.5194/jbji-11-277-2026
© Author(s) 2026. 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-11-277-2026
© Author(s) 2026. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
The use of debridement, antibiotic pearls, and implant retention (DAPRI) in the management of acute periprosthetic joint infections: a systematic review
Doriana Di Costa
Department of Orthopaedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Giacomo Capece
Department of Orthopaedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Donato Coppola
CORRESPONDING AUTHOR
Department of Orthopaedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Elena Matteini
National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
Pierluigi Del Vecchio
UOC Malattie Infettive, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Francesco Taccari
UOC Malattie Infettive, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Giuseppe Maccagnano
UOC Ortopedia e Traumatologia Universitaria, Azienda Ospedaliero Universitaria “Ospedali Riuniti” di Foggia, Foggia, Italy
Carlo Torti
Sezione Malattie Infettive, Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Rome, Italy
UOC Malattie Infettive, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Giulio Maccauro
Department of Orthopaedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Raffaele Vitiello
Department of Orthopaedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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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.
Alessandro Singlitico, Daniele Grassa, Rami Kaplan, Alessandro Smimmo, Giulio Maccauro, and Raffaele Vitiello
J. Bone Joint Infect., 10, 85–92, https://doi.org/10.5194/jbji-10-85-2025, https://doi.org/10.5194/jbji-10-85-2025, 2025
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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.
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
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.
This systematic review evaluates debridement, antibiotic pearls and implant retention (DAPR) as...