Bacteriophage therapy is a promising treatment for periprosthetic joint infections (PJIs), particularly given these agents have innate abilities to degrade the biofilm matrix and lyse bacteria within. However, many aspects of this therapy are poorly understood causing treatments to lack uniform effectiveness and reproducibility, which is in part a consequence of several inherent limitations to using bacteriophages to treat PJI. Herein, these limitations are discussed as are additional translational research that needs to be conducted to advance this therapeutic. These include determining if bacteria causing PJIs are polyclonal, consequences of bacteriophage attachment receptor phenotypic variations and ramifications of bacteriophage activity when bacteria interact with in vivo macromolecules. Only with the realization of the current limitations and subsequent knowledge gained from translational research will the potential of bacteriophages to reduce the morbidity and mortality in PJI be fully elucidated.

中文翻译：

---

假体周围关节感染的噬菌体疗法：当前的局限性和推进该疗法所需的研究

噬菌体疗法是​​治疗假体周围关节感染 (PJI) 的一种很有前途的治疗方法，特别是考虑到这些药物具有降解生物膜基质和裂解其中细菌的先天能力。然而，对该疗法的许多方面知之甚少，导致治疗缺乏统一的有效性和可重复性，这在一定程度上是由于使用噬菌体治疗 PJI 的几个固有局限性的结果。在此，讨论这些局限性以及需要进行的额外转化研究以推进这种治疗。这些包括确定引起 PJI 的细菌是否是多克隆的、噬菌体附着受体表型变异的后果以及当细菌与体内大分子相互作用时噬菌体活性的分支。