Since there is no consensus on the optimal perioperative analgesic method, the present article provides a brief and practical synthesis on current multimodal pre–postsurgery analgesia protocols for primary TKA (excluding intraoperative anesthetic techniques) reported especially in recent meta-analyses and reviews. The focus is not only on the traditional aims (pain scores and opioid sparing), but also the functional recovery and patient-reported outcomes. Multimodal analgesia (pre-emptive analgesia, local infiltration analgesia, peripheral nerve blocks, and specific systemic drugs) is considered the optimal regimen for perioperative pain management of TKA.

Despite ongoing efforts to enhance diagnostic and treatment processes, the success rate for eradicating infections, particularly prosthetic joint infections (PJIs), currently stands at around 50%. For acute infections occurring shortly after arthroplasty, guidelines recommend a treatment known as DAIR (debridement, antibiotics, and implant retention). This approach is suggested for infections within 30 days post-arthroplasty or with less than 3 weeks of symptoms, provided that there is a stable implant and adequate soft-tissue mass. Several authors have suggested extending the use of DAIR beyond the initial 3-week period in specific cases. This extension practice seems increasingly feasible due to the rapid diagnostic capabilities offered by BioFire^®. This technology allows for quick pathogen identification, aiding in the exclusion of cases that do not fit the criteria for the DAIR/DAPRI (debridement, antibiotic pearls and retention of the implant) protocol based on pathogen identification. The aim of this review is to re-examine the current literature on acute infections and present our proposed “prosthesis-saving” protocol, which integrates the BioFire^® molecular diagnostic system. Continued research and assessment of the efficacy and safety of these protocols, especially regarding extended treatment timelines, are crucial for advancing the management of acute infections and enhancing outcomes for PJI patients.