Functional biomaterials for the treatment of periprosthetic joint infection: A systematic review of preclinical animal studies
Abstract
Background: Periprosthetic joint infection (PJI) is a serious complication following joint arthroplasty, often leading to implant failure, bone destruction, and high revision rates. Conventional treatments are limited by biofilm persistence and collateral tissue damage. Functional biomaterials, defined as materials with active therapeutic properties such as antimicrobial delivery, biofilm disruption, tissue regeneration, or immunomodulation, offer promising alternatives. This systematic review aims to evaluate the current landscape of functional biomaterials in preclinical PJI models and identify translational challenges. Methods: A systematic search of PubMed, Web of Science, and Embase was conducted for studies published between January 2000 and April 2025. Inclusion criteria were preclinical studies using validated animal models of PJI and investigating biomaterials with at least one active therapeutic function. Studies without prosthetic joint components or lacking in vivo data were excluded. Two reviewers independently screened and extracted data, and risk of bias was assessed using SYRCLE's tool. Results: 23 studies met the inclusion criteria, covering a range of biomaterial platforms including polymer-based systems, metal-based materials, cement and inorganic materials, nanomaterials, and hydrogels. These materials demonstrated diverse mechanisms and delivery strategies, such as localized antibiotic release and biofilm disruption. However, limitations persist in model…
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Evidence Hub reads this as a systematic review, done in animal, not in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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