In recent decades, there has been a growing emphasis on the use of local antibiotics in orthopaedic surgery, but development of new technologies has been limited. In this study we observe that a 1.5 mL injection of the novel technology CarboCell G/C into the bone provides very high levels of the antibiotics gentamicin and clindamycin in bones, with almost no spill to the bloodstream. These findings bolster the prospect of new and improved technologies for combatting orthopaedic infections.

Fracture-related infections (FRIs) and periprosthetic joint infections (PJIs) fail to recover pathogens, posing a diagnostic challenge and impacting treatment. This new method involves homogenising biopsies with beads to release bacteria, followed by inoculation in blood culture bottles using an automated system. This technique shows similar sensitivity to conventional methods, with improved specificity and faster pathogen detection. To date, no other studies have reported an optimized method for incubating biopsies from patients with FRIs.

We performed a mixing lab study describing 20 additional mixing formulas with mixing/set times in creating antimicrobial CaSO₄ beads used for local delivery in periprosthetic joint infections, fracture-related infections, and other bone site infections. Most new formulas were focused on antifungal and antimycobacterial therapy. This information is to be utilized as an open-access reference for all physicians involved in the treatment of musculoskeletal infections.

Synovial fluid pH, lactate, and glucose levels have been studied in native joint septic arthritis, but their diagnostic value in periprosthetic joint infection (PJI) remains insufficiently explored. This prospective study of 100 patients assessed their utility for PJI diagnosis. PJI cases showed significantly lower synovial pH and glucose levels but higher lactate levels. The combined analysis of all three biomarkers yielded a negative predictive value of 84 % for PJI diagnosis.

Arthrofibrosis after total knee arthroplasty (TKA) remains a challenging complication. We analysed 19 TKA cases, isolating low-virulence pathogens in 43 % of them. Although a causal link with low-grade peri-prosthetic joint infection (PJI) is unconfirmed, our findings support its potential role in arthrofibrosis. If validated, this could shift the therapeutic approach toward PJI-oriented management.

Patients with a periprosthetic infection (PJI) have a bad functional outcome and can suffer from a PJI-triggered psychological burden.  Although this has been studied, it is still unclear how to properly screen patients for mental disorders caused by a PJI. Our study showed that the hospital anxiety and depression scale – total (HADS-T) is a valid screening tool for PJI patients and that PJI patients with high HADS-T scores should specifically be offered psychological support.

Proteus is a rare form of bacteria in periprosthetic joint infection (PJI) following knee and hip arthroplasties. In this study, we investigated culture-positive revision surgeries from 2008 until 2024. Proteus species were mainly found in hip arthroplasties. Furthermore, the infections of Proteus species were mainly prevalent in chronic revisions alongside multiple bacteria. Given their chronic and polymicrobial nature, the outcome of Proteus-associated PJIs is poor. 

Bone and joint infections often require prolonged antibiotic treatments over 12 weeks. Dalbavancin, an intravenous antibiotic given at spaced intervals, offers a promising option. Our study developed a method to optimize dosing schedules using two blood tests to measure drug levels. This ensures effective treatment while avoiding excessive accumulation. These findings suggest dalbavancin is a safe, effective choice for managing long-term infections.

We retrospectively compared outcomes of two-stage revision with three common spacer types. No significant difference in failure rate was seen across groups, contributing evidence of similar efficacy. Articulating spacers showed a greater range of motion than static spacers, and static spacers were associated with a higher adverse event rate, directly showing potential advantages and disadvantages of each variant. A trend toward a longer interstage duration for prosthetic spacers may reflect greater functionality.

This study's aim was to analyse the healing and failure rates of one-stage knee replacement in patients with positive and negative preoperative cultures and sinus presence.  We concluded that culture-negative infections or the presence of a sinus tract showed similar results compared to patients that had undergone the same procedure with positive cultures or spared soft tissue.

This retrospective study compared debridement and implant retention failure for three types of acute knee replacement infection and analyzed outcomes for patients in a cohort with low medical risk. No differences in failure rate were seen between types in the overall sample or “optimal” cohort. Staphylococcus aureus was less common in later infection, while Streptococcus was less frequent in earlier infection. In an optimal patient, similar outcomes between types may suggest that medical factors do not alter risk.

Patients with rheumatoid arthritis have a high treatment failure rate when faced with a late acute periprosthetic joint infection. Because of the rarity of the condition, we performed a multicenter case-control study. We identified predictors of treatment failure to ultimately improve the treatment outcome. Exchange of modular components seems important in this patient group, likely due to a higher rate of positive blood cultures compared to control patients.

This study explores the effectiveness of repeated debridement, antibiotics, and implant retention (DAIR) for early periprosthetic joint infections (PJIs) after total joint arthroplasty. It shows that repeated DAIR procedures may achieve over 75 % success, which indicates that this approach may have value in managing early PJIs after weighing the benefits and risks of repeated DAIR against implant removal for each patient.

Diabetic foot osteomyelitis is a severe diabetes complication that increases the risk of limb loss and death. This study assessed a one-stage surgical approach with primary wound closure and local antibiotics, showing favourable results. Among 97 patients, 13 needed further treatment, but only 4 required major amputation. Poor circulation was the main factor in failure. These findings challenge traditional methods and may improve quality of life, although further high-quality trials are needed.

We report the first case of axillary nerve neuropathy in an adult secondary to shoulder septic arthritis with abscess formation. Prompt surgical drainage, lavage, and targeted antibiotic therapy led to full recovery. This case also highlights the risks of intra-articular injections, particularly in immunocompromised patients, and underscores the importance of maintaining a high index of suspicion for septic arthritis in this population, even when the classic signs are absent.

We compared the outcomes of one-stage and two-stage revision surgeries for periprosthetic joint infections of the knee and hip joints. Patients in both groups had similar reinfection rates and functional recovery, but two-stage hip patients experienced more complications, partly due to the temporary use of cement spacers. Our findings suggest that one-stage revision may be a viable alternative to two-stage revision, potentially reducing complications without increasing reinfection risk.