Psychological burden of bone and joint infections: Systematic review on mental health and quality of life implications

BACKGROUND Bone and joint infections (BJIs), such as periprosthetic joint infections and fracture-related infections, are severe complications in orthopedic surgery with profound physical, social, and psychological consequences. While their physical and economic impacts are well documented, the psychological burden remains underrecognized. AIM To systematically review the existing literature on the impact of BJIs on mental health and quality of life, and to identify validated tools used to assess these outcomes. METHODS Systematic review was conducted on PubMed and Scopus database. Seventeen studies published between 2010 and 2024 were included (5 qualitative, 12 quantitative). RESULTS Qualitative findings revealed consistent emotional suffering, including fear, helplessness, depression, and social withdrawal, especially during the interim phase of two-stage revisions. Quantitative studies confirmed a significant deterioration in mental health, even after clinical resolution of the infection. Among the tools employed, the International Classification of Diseases-10-Symptom Rating and the Hospital Anxiety and Depression Scale emerged as the most sensitive for detecting psychological distress. CONCLUSION Despite growing awareness, there is still a lack of specific psychological interventions and standardized assessment protocols for this vulnerable patient population. These findings underscore the urgent need for integrating mental health evaluation and support into comprehensive BJI treatment strategies to improve outcomes and long-term quality of life.