Robotic platforms, proprietary registries, and advanced analytics have transformed total joint arthroplasty into a data-intensive subspecialty. Contemporary procedures generate granular operative metrics that are increasingly linked to longitudinal outcomes, benchmarking systems, predictive analytics, and artificial intelligence algorithm development. Yet governance structures defining analytic access, publication rights, secondary data use, and transparency to patients remain incompletely articulated. Surgeons generate operative data, but vendors frequently warehouse and structure these data sets within proprietary ecosystems, while registry governance and contractual agreements may influence analytic access and dissemination. These challenges extend beyond privacy concerns. Arthroplasty data sets increasingly inform quality measurement, reimbursement models, public reporting, and future algorithm development. Without clear governance standards, control over data stewardship, analytic framing, and scientific dissemination may progressively shift away from practicing surgeons and patients. This Viewpoint article examines emerging governance-related challenges within arthroplasty data ecosystems and proposes a framework centered on transparency to patients, data portability, publication protections, and independent oversight. The goal is not to impede innovation, but to ensure that the expanding digital architecture of arthroplasty evolves within transparent, ethically grounded, and academically independent governance structures.

➢ Periprosthetic joint infection (PJI) remains the most common cause of failure after total joint arthroplasty, with current standard therapies associated with failure rates between 10% and 30%.➢ The 2025 International Consensus Meeting in Istanbul, Türkiye, highlighted the potential benefits of bacteriophage (phage) therapy in managing PJI.➢ One of the barriers to integrating phage therapy into standard clinical PJI care is the knowledge gap between preclinical research and clinical practice.➢ This Expert Review summarizes the key therapeutic advantages of using phages as an adjuvant therapeutic platform for PJI. It also highlights the current challenges that are continuing to limit the integration of phages into standard PJI care.