The promising role of bacteriophage therapy in managing total hip and knee arthroplasty related periprosthetic joint infection, a systematic review

Journal of Experimental Orthopaedics

Review Paper

Ahmed A. Khalifa¹  Sarah M. Hussien² 

[1] Orthopaedic Department, Qena Faculty of Medicine and University Hospital, South Valley University, Kilo 6 Qena-Safaga Highway, 83523, Qena, Egypt;Qena Faculty of Medicine, South Valley University, Qena, Egypt;Qena Faculty of Medicine, South Valley University, Qena, Egypt;

关键词: Bacteriophage therapy;    Periprosthetic infection;    Total hip arthroplasty;    Total knee arthroplasty;   

DOI  :  10.1186/s40634-023-00586-z

 received in 2022-11-02, accepted in 2023-02-08,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeTotal hip and knee arthroplasty periprosthetic joint infection (PJI) poses a management dilemma owing to the emergence of resistant organisms. A promising option is Bacteriophage therapy (BT) was used as an adjuvant for PJI management, aiming at treating resistant infections, decreasing morbidity, and mortality. The current review aimed to demonstrate the role and safety of using BT as an adjuvant to treat PJIs.MethodsA systematic search was performed through four databases (Embase, PubMed, Web of Science, and Scopus) up to March 2022, according to the predetermined inclusion and exclusion criteria.ResultsOur systematic review included 11 case reports of 13 patients in which 14 joints (11 TKAs and three THAs) were treated. The patients’ average age was 73.7 years, underwent an average of 4.5 previous surgeries. The most common organism was the Staphylococcus aureus species. All patients underwent surgical debridement; for the 13 patients, eight received a cocktail, and five received monophage therapy. All patients received postoperative suppressive antibiotic therapy. After an average follow-up of 14.5 months, all patients had satisfactory outcomes. No recurrence of infection in any patient. Transaminitis complicating BT was developed in three patients, needed stoppage in only one, and the condition was reversible and non-life-threatening.ConclusionBT is a safe and potentially effective adjuvant therapy for treating resistant and relapsing PJIs. However, further investigations are needed to clarify some BT-related issues to create effective and reproducible therapeutics. Furthermore, new ethical regulations should be implemented to facilitate its widespread use.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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