Periprosthetic joint infection is the most challenging complication following arthroplasty. This study, utilizing clinically obtained synovial fluid specimens, confirmed the unique value of neutrophil extracellular traps and their constituent components in the diagnosis of periprosthetic joint infection, thereby enabling further precision in the diagnosis of periprosthetic joint infection and reducing the severe consequences associated with it.

Gram-negative prosthetic joint infections are challenging. Robust European multicentre data remain limited. This study provides contemporary epidemiological and microbiological data from three tertiary centers across three European countries. We identify patient risk profiles and pathogen-related differences in treatment success. These findings offer novel, practical evidence to guide individualized management of gram-negative prosthetic joint infection (PJI).

For over a decade, orthopaedic surgeons have sprinkled vancomycin powder into surgical wounds to prevent infection. New large randomised trials show this is ineffective in hip and knee replacements, though possibly useful in high-risk fracture surgery and infected revision cases. Based on these findings and international guidelines, we propose a framework that identifies specifically in which operations this antibiotic powder may still have a role and in which it should be avoided.

We surveyed physicians in the United States who specialize in bone and joint infections to better understand how their work is financially supported. Most respondents reported spending substantial time on patient coordination, education, and multidisciplinary planning that was not directly reimbursed or protected by dedicated funding. These findings suggest current payment models may not adequately support the complex team-based care required for serious orthopedic infections.

Total joint arthroplasty is increasingly common in the US, with an expected rise in periprosthetic joint infection (PJI). Limited evidence exists of PJI risk in new primary arthroplasty in patients on chronic suppression for prior PJI. Due to a lack of evidence examining this population, shared decision-making must be informed by medical comorbidities and patient-related risk factors, infectious history, and the current evidence of PJI treatment and infection control measures.

This study assessed the reliability of the tumor, node, and metastasis (TNM) classification for periprosthetic joint infection (PJI) in patients with acute and chronic infections after hip replacement. Using a large clinical cohort, we found that clinicians with different levels of experience applied the system consistently. These findings support its use for describing disease severity, improving communication, and supporting future research and treatment planning.

This is a study that included our daily practice with a cohort of patients with prosthetic joint infection (PJI) of the knee or hip, that had admissions with concern for PJI, and had surgery for that. Synovial aspiration and cultures were compared with intraoperative culture results. Our concordance rate (yielding the same organism(s) or if both were negative) between synovial and intraoperative cultures was almost 75 %, with low frequency of culture-negative and few polymicrobial PJI.  

Sinus tracts communicating with the prosthesis demonstrated high specificity and support their use as a confirmatory criterion for periprosthetic joint infection (PJI). Purulence also showed high specificity but may be better considered to be a suggestive criterion due to challenges in clinical differentiation. Both findings were associated with distinct microbiological patterns and less favourable outcomes, highlighting their clinical relevance.

Staphylococcus aureus nasal colonization is a key contributor to postoperative infection after hip and knee replacement. We review current evidence on screening and nasal decolonization, highlighting that reliable decolonization is more critical than screening alone. We summarize practical treatment options and propose a simple, standardized preoperative protocol that can be implemented in routine arthroplasty pathways to reduce preventable infections.

This study aims to identify characteristics associated with septic arthritis in patients who have inconclusive laboratory findings. This would potentially allow for improved ability to identify a pathology that can be marked by ambiguity.  

We found three characteristics associated with increased risk of septic arthritis. Additionally, we found that lowering historic thresholds may be appropriate in order to prevent missed or delayed diagnosis of a pathology with considerable morbidity.

This systematic review evaluates debridement, antibiotic pearls and implant retention (DAPR) as a treatment option for acute periprosthetic joint infection. Analysis of available clinical studies shows encouraging infection control rates with few complications, suggesting that this approach may help to preserve implants in selected patients. However, current evidence is limited, and larger well-designed studies are needed to confirm its effectiveness and clarify its role in clinical practice.

This study examined how people with difficult joint infections manage long-term antibiotic treatment when the infection cannot be fully removed. We followed patients to record side effects and overall well-being. Many had stomach or skin problems, but most continued treatment. The results show that attentive follow-up and personalised care keep this therapy manageable and may guide better support in practice.

CarboCell is an injectable material designed to release antibiotics directly where bone infections occur. We tested it in animals and found that it delivered high and long-lasting drug levels in bone while keeping drug levels in the rest of the body very low. This suggests that CarboCell may improve infection treatment and reduce the need for whole-body antibiotic therapy.

Synovial pH, lactate, and glucose are established biomarkers for joint infection but are usually analyzed in central laboratories. In this prospective analytical agreement study, we evaluated whether blood gas analyzers can measure these parameters at the point of care. Blood gas analyzer measurements showed good to excellent agreement with laboratory reference methods, particularly for lactate and glucose, supporting their use for rapid diagnosis of native and periprosthetic joint infection.

We studied hip and knee prosthetic joint infections  caused by Staphylococcus epidermidis, a common pathogen that can form biofilm on implants. We reviewed over 100 cases to understand how antibiotic resistance affects treatment success. We found that infections resistant to rifampin, levofloxacin, or multiple antibiotics showed a higher failure rate. These findings may help surgeons choose the best surgical and antibiotic treatment approach for patients.

Early postoperative orthopaedic infections require rapid empirical antibiotic treatment, but the optimal regimen may differ by anatomical site. In this retrospective cohort study, empirical coverage was evaluated across anatomical sites. Vancomycin combined with ceftriaxone provided high coverage for most sites, while foot and ankle infections showed higher rates of resistant Gram-negative bacteria. These findings support an anatomy-specific approach to treatment.

This article outlines 20 common errors in the prevention, diagnosis, and management of fracture-related infection (FRI), highlighting their clinical consequences and providing practical recommendations for avoiding them. By addressing typical pitfalls and emphasizing standardized procedures and interdisciplinary collaboration, the article aims to improve patient safety and treatment outcomes.

Segmental bone loss remains a major challenge, often worsened by fracture-related infection (FRI). Surgical debridement and tissue cultures are key initial steps. Bone transport, utilizing distraction osteogenesis, remains a key therapeutic strategy. Innovations like integrated fixation and motorized nails reduce patient morbidity. Management relies on a multidisciplinary approach. This review explores current and emerging concepts in the field of bone transport, focusing on FRI.

Disseminated Mycobacterium abscessus infection is a rare clinical presentation that is challenging to treat due to the limited number of therapeutic options available. This complex case involved multi-speciality input across two hospitals. In the absence of guidelines for the management of extra-pulmonary and disseminated disease, our case  highlights which pharmacological agents were used and how surgery was utilised to achieve source control.

Septic arthritis is a dangerous joint infection that requires rapid treatment. We analysed patient data to test common blood and synovial fluid markers and a newly developed composite score combining these markers. The score demonstrated higher sensitivity than individual tests alone within this dataset. Prospective validation in larger cohorts is required before clinical application.