Recent  

We describe 48 osteocutaneous-flap-related osteomyelitis cases, mostly presenting with early, local signs of infection and/or bone exposure. Main pathogens were Gram-negative bacilli, streptococci, S. aureus, enterococci, and anaerobes, justifying a broad-spectrum empirical antimicrobial therapy. Despite surgery and a 3-month antimicrobial therapy, a 50 % failure rate was recorded, associated with a delayed infectious disease specialist referral and advocating for multidisciplinary management.

A simulated large joint model has been established to help better understand the elution mechanics of antimicrobial agents and the devices used to deliver them to a large human joint. This model is unique to previously published models in that it more accurately represents the environment of a large human joint. The model was employed to evaluate four brands of commercial medical-grade calcium sulfate. These products were evaluated in both an unaltered state and when mixed with antibiotics.

A patient with normal D-dimer value has a low risk of prosthetic joint infection, so serum D-dimer assessment should always be considered as a useful test to rule out chronic prosthetic joint infection (especially in those cases caused by low-virulence microorganisms in which conventional tests may lead to misdiagnosis). Conversely, the platelet count to mean platelet volume ratio may be of limited value for accurately diagnosing prosthetic joint infection.

The use of dissolving local antibiotic delivery systems in orthopedic surgery is improving the way we treat infection. Early analysis of a small cohort suggests that antibiotic-loaded calcium sulfate-coated interlocking intramedullary nails (CS-IMN) are safe and may be as effective as the more established method for infection eradication. Future studies with larger cohorts of patients will be required to confirm these findings.

Periprosthetic joint infection (PJI) is a complication of total joint arthroplasty, and treatment failure rates are still quite high. This study has developed a novel rabbit model of PJI that provides an opportunity to introduce treatments during ongoing infection, with readouts including a quantifiable method to assess biofilm coverage on implants via scanning electron microscopy (SEM).

Arthroplasty after septic arthritis (SA) raises diagnostic and therapeutic questions. We report on 49 knee and hip arthroplasties following SA. Median SA-to-arthroplasty interval was 32 weeks, and one-stage arthroplasty was performed in 43 episodes. No SA relapse but 5 new prosthetic joint infections occurred with an infection-free survival rate of 96 % at 2 years. Arthroplasty may be a post-SA option, even within a short period of time but requires specific management and prolonged monitoring.

This is a case report and literature review that describes Listeria monocytogenes as a rare cause of native vertebral osteomyelitis. This work reviewed previous published cases (nine cases to the best of our knowledge) and documented the clinical course, diagnostic challenges, and treatment of the disease. This case report aims to inform clinicians of the possibility of Listeria monocytogenes invading native joints in patients with or without risk factors.

This case report is the first description of severe metabolic acidosis due to flucloxacillin therapy without relevant comedication that we know of. The described patient had been treated with flucloxacillin for 14 d due to intraoperative evidence of multisensitive Staphylococcus aureus due to periprosthetic shoulder infection. In patients on flucloxacillin therapy, acidosis should therefore always be considered as a differential diagnosis of tachypnoea or impaired mental status.

The treatment of diabetic foot osteomyelitis requires a multidisciplinary approach. The optimal duration of systemic antibiotic therapy after surgical debridement or amputation is currently unknown. In recent years, emerging research on this clinical topic has been carried out. Therefore, we review the current knowledge and recommendations regarding the duration of antibiotic therapy for diabetic foot osteomyelitis.

Prosthetic joint infection is a complicated problem, where reinfection can occur. Understanding risk factors for failure helps optimize care. This study investigated if the presence of a draining sinus tract was correlated with failure of two-stage revision. Previous cases were reviewed at our institution over a 10-year period. Patients with a sinus tract were significantly less likely to be replanted compared to those without a sinus tract at presentation.