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Despite potential pharmacokinetic advantages, the local application of antibiotics in the treatment of periprosthetic joint infections has so far been associated with bad outcomes. This study shows a major advantage for the local application of antibiotics with calcium sulfate as the carrier material in the implant-retaining treatment of a periprosthetic joint infection of the hip.

A low-grade periprosthetic joint infection (PJI) may be difficult to diagnose, and nuclear imaging could help in the diagnosis. However, its diagnostic value is unclear. We retrospectively evaluated this diagnostic value. We conclude that in patients presenting with nonspecific symptoms and a low a priori chance of PJI based on clinical evaluation, nuclear imaging is of no clear added value in diagnosing a PJI.

We present a series of patients with chronic post-traumatic osteomyelitis (CPTO) of the femur or tibia who were treated either with custom-made or commercially available antibiotic cement-coated nails. The overall infection control rate was 96.6 %, with reoperation and failure rates of 26.6 % and 3.3 %, respectively. Custom-made antibiotic-coated nails were associated with significantly longer operating times and higher rates of cement–nail debonding during removal.

Cutibacterium acnes is a bacterium responsible for most postoperative infections in orthopaedic shoulder surgery. There is currently a number of studies describing measures to reduce bacterial burden on the skin prior to surgery. In these studies it is rarely explained what bacterial sampling technique has been used. This study compares three different swab techniques and concludes that the new pencil eraser swab technique may be the best in detecting bacteria.

This study reports a rate of deep surgical site infection (SSI) of 0.2 % in a cohort of patients treated surgically for osteoarthritis of the hip at the 90 d review mark using CDC/NHSN criteria for diagnosis. This work establishes a reliable population-based baseline infection rate for early-onset deep SSI after total hip arthroplasty for osteoarthritis. It also provides valuable insight into risk factors associated with developing an early-onset deep SSI.

Adding immunologic evaluation to the Cierny–Mader classification more accurately determines patients’ true host status and better quantifies risk and outcome with respect to orthopedic infection. Immunologically deficient A hosts should be quantified as B hosts. IgG deficiencies can be addressed with supplementation. IgG replacement should be considered in patients with recurrent orthopedic infections.

This paper presents a series of patients with complex periprosthetic joint infection of the knee and concomitant soft tissue defects managed with revision knee surgery and a gastrocnemius flap. We show that this flap can be safely performed by appropriately trained orthopaedic surgeons and confirmed the previous literature findings that patients presenting with this problem have high rates of persistent infection.

We report on an 83-year-old woman who had an open removal of a baker's cyst several months after total knee arthroplasty. The following wound healing problem was first misinterpreted as being superficial. With an injection of methylene blue and a contrast medium, we showed the extent of the sinus tract, proving the periprosthetic joint infection.

Chronic osteomyelitis is a bone infection and was treated with a combination of antibiotics and two surgeries. With the introduction of the biomaterial S53P4 bioactive glass, these infections can be treated with antibiotics and one surgery. This study shows 85 % success in the treatment of these bone infections. Together with the fundamentally different antibacterial mechanisms without antibiotic resistance, S53P4 bioactive glass is recommendable for the treatment of these infections.

The use of calcium sulfate as an antibiotic delivery vehicle is a growing treatment option used by surgeons in the face of infection following joint replacement surgery. Calcium sulfate can be mixed with antibiotics and formed into small beads, which can be delivered during surgery to the local site of infection. We performed a mixing study to formalize mixing methods for individual and combined antibiotics with a synthetic calcium sulfate product. We report our mixing formulas and set times.

This paper describes an ultrasound guided technique for aspiration of hip arthroplasties that has not been published. We believe this technique is important because it yields useful fluid 99 % of the time with low contamination rate (2 %). Ultrasound, although common in Europe, is gaining popularity in the United States. Besides teaching a useful technique, this paper also discusses findings of lavage-obtained samples which are rarely discussed in other aspiration papers.

The sternoclavicular joint is an uncommon location for septic arthritis and exceedingly rare in the healthy population. Diagnosis is often delayed by poorly localized symptoms and misdiagnosis, as was observed in our patient and which can result in life-threatening complications. We highlight the importance of proper clinical examination and adequate imaging for diagnosis and identification of its complications, as well as the need for multidisciplinary collaboration during treatment.

This study provides a comprehensive overview of a frequently used treatment strategy for chronic prosthetic joint infection of the hip and knee. Forty-seven patients met the inclusion criteria. Successful eradication was achieved in 36 of 47 cases. Multiple variables were analysed to explore their influence on the outcome of two-stage revision surgery. No variables were found to have a significant influence. Mean follow-up of over 10 years provides a good perspective of the long-term outcome.