Biopsychosocial needs and complementary treatments for patients undergoing management for periprosthetic joint infection following hip or knee arthroplasty: a systematic review

Purpose: A periprosthetic joint infection (PJI) is considered the most drastic complication after hip/knee arthroplasty. Despite extensive research into PJI treatment, insights into patients' biopsychosocial needs are sparse. The aim of the current review is to provide an overview of patients' biopsychosocial needs and interventions aimed at these needs. Methods: A systematic review incorporating a comprehensive database search of seven major scientific databases. Articles were included if they reported on the biopsychosocial needs of patients with PJI and on interventions aimed at these needs. Quality of the included studies was assessed by two reviewers with the Mixed Methods Appraisal Tool. Characteristics of included studies and the associated results were extracted. Results: Of the 9,745 identified research articles, 20 were included in the review. All of the included articles reported about biopsychosocial needs, but only two (10%) of them also reported on interventions focused on these needs. Psychological needs were reported most often (n = 19, 95%), followed by physical (n = 14, 70%) and social needs (n = 8, 40%). Improving mental health was the most frequently reported psychological need (n = 13, 65%). Functional improvement emerged as the most common identified physical need (n = 12, 60%), while social support from healthcare professionals (n = 5, 25%) was the most reported social need. Conclusion: The results show a clear need for interventions on top of the primary surgical treatment for patients diagnosed with PJI, especially for psychological and physical support. Interventions targeting needs were described in only two articles (10%) in the current literature. Future studies should explore patient-centered approaches and integrate psychological and physical management into PJI treatment pathways to improve outcomes.