Periprosthetic joint infections in total hip arthroplasty: an integrative review of risk factors, pathogens, and treatment strategies

Abstract

Objective This study aims to analyze the main risk factors, infectious agents, and treatment protocols for periprosthetic joint infections (PJI) in total hip arthroplasty (THA). Methods A systematic search was conducted in PubMed and related databases for articles published between 2015 and 2025. Studies addressing PJI in THA were included, focusing on clinical outcomes, diagnostic strategies, and therapeutic protocols. Data were descriptively analyzed based on 55 relevant studies. Results Significant risk factors identified include obesity, diabetes,

and prior surgical interventions. The primary causative agents were Staphylococcus aureus and Gram-negative bacteria, with fungal infections, though rare, presenting unique challenges. Among therapeutic strategies, two-stage revision surgeries exhibited the lowest failure rates for

chronic infections, particularly with the use of antibiotic- loaded cement spacers and multidisciplinary approaches.

Conclusion PJI in THA remains a clinical challenge requiring early diagnosis and individualized treatment. Multidisciplinary approaches and robust prevention protocols significantly improve clinical outcomes.