Medicinal, Psychological, and Health Research Journal (MPHRJ)

Abstract Introduction: Total knee arthroplasty is an effective treatment for advanced knee disorders but remains vulnerable to postoperative infections, including periprosthetic joint infection, which can lead to serious complications and increased healthcare burden. Antibiotic prophylaxis is widely used to reduce this risk, yet optimal strategies remain debated. Therefore, this study aims to systematically review the evidence regarding the effectiveness of antibiotic prophylaxis in preventing infection following TKA.

Material and methods: This systematic review was conducted according to PRISMA guidelines. Eligible studies included randomized and observational research evaluating antibiotic prophylaxis in adult patients undergoing total knee arthroplasty with reported postoperative infection outcomes. Multiple databases were searched using MeSH terms and related keywords by two independent reviewers. Study quality was assessed using the Newcastle–Ottawa Scale and the Cochrane Risk of Bias tool.

Results: The literature search identified 851 records, of which nine studies met the inclusion criteria after screening and full text assessment. Overall, intravenous antibiotic regimens demonstrated moderate to high treatment success across studies, with reported success rates ranging from 63% to 90% and follow up durations varying between 3.5 and 72 months. Most regimens involved glycopeptide or rifampicin based therapies administered for approximately 2–6 weeks, with generally favorable clinical outcomes.

Conclusion: The available evidence suggests that intravenous antibiotic therapy provides generally favorable outcomes in the management of infection related complications. Across the included studies, treatment success was consistently moderate to high despite variations in antimicrobial regimens, treatment duration, and follow up periods. Glycopeptide and rifampicin based therapies appear to play a central role in achieving effective infection control.

Abstract Introduction: Prosthetic joint infection (PJI) remains one of the most serious complications following total knee arthroplasty, leading to substantial morbidity, repeated surgical procedures, and increased healthcare burden. These infections are primarily driven by bacterial colonization and biofilm formation on implant surfaces. Given the variability in reported causative microorganisms, the aim of this study was to systematically review the literature to identify the bacterial pathogens most commonly associated with PJI after total knee arthroplasty.

Material and methods: This systematic review followed PRISMA guidelines to identify bacterial pathogens associated with prosthetic joint infection after total knee arthroplasty. Studies were retrieved from PubMed, Web of Science, ScienceDirect, and Google Scholar using structured keywords. Two reviewers independently screened articles, and methodological quality of eligible observational studies was assessed using the Joanna Briggs Institute appraisal tools.

Results: Across four published case reports (n = 4), Ruminococcus/Mediterraneibacter gnavus was implicated in prosthetic joint infection (25%), deep surgical site infection (25%), bacteraemia (25%), and septic arthritis (25%), predominantly in elderly or immunocompromised patients. Identification relied on MALDI-TOF and/or 16S rRNA sequencing in all cases (100%), and favorable clinical outcomes were achieved with combined surgical management and targeted antibiotic therapy in the majority of reported infections.

Conclusion: Mediterraneibacter gnavus should be recognized as a rare but clinically significant opportunistic pathogen capable of causing orthopedic and systemic infections. Accurate diagnosis depends on advanced microbiological techniques, and outcomes appear favorable with timely surgical intervention and targeted antimicrobial therapy. Increased awareness may facilitate earlier detection and appropriate management.