Recent  

Upper extremity abscesses frequently present to the acute care setting with inconclusive physical examination and imaging findings. This study sought to evaluate the diagnostic accuracy of various serum inflammatory markers that are commonly used in the diagnosis of other types of infections. Results demonstrated that C-reactive-protein, an acute phase inflammatory marker, is the most sensitive test, but it is the least specific.

While there is no gold standard test to diagnose periprosthetic joint infection (PJI), we believe synovial fluid analysis, especially preoperatively, is a critical step in differentiating between infection and aseptic failure. Adding simple and inexpensive biomarkers such as synovial C-reactive protein (CRP) or adenosine deaminase (ADA) and combined interpretation can be helpful in the context of inconclusive results.

Magnetic resonance imaging (MRI) is an imaging test that is often used in patients with a suspected bone infection in their foot. MRI findings may impact how these patients are treated; thus, it is important to understand the significance of various MRI findings. This study compared different patterns of MRI findings in these patients to their clinical outcomes. Patients with classic features of bone infection on MRI had the worst outcomes, whereas patients without them sometimes healed.

Sometimes after surgery to repair an injured bone or joint, infection can cause the bone to heal improperly. Surgeons use calcium sulfate to prevent infections in joints after surgery. Calcium sulfate can be impregnated with antibiotics and placed inside the joint, where the bloodstream often cannot deliver intravenous or oral antibiotics effectively. We reviewed 20 years of studies of the effectiveness of calcium sulfate and found high rates of healing and infection eradication.

Bone infections are challenging to treat and require new treatments. The current animal models for testing new therapies can be expensive and complex; therefore, we developed a cheap and reliable bone infection model in mice. Our new model features an infected hole created by a needle in the leg bone with a metal pin. This method achieved a consistent infection rate and demonstrates the importance of bacterial biofilm in bone infection.

In a low-resource setting, we studied the risk factors for infection in 101 open fractures treated with the SIGN nail. We found that infection of fractures increased with fracture severity. The treatment-related factors found to have significant association with infection were also essentially the same as those known in advanced countries. We believe low-resource settings could affordably adopt management approaches of high-income countries to achieve good outcomes despite the scarce resources.

The relation between postoperative wound leakage and occurrence of a prosthetic joint infection (PJI) after arthroplasty has not been investigated in a prospective study. We performed a large cohort study in which 1019 patients, after arthroplasty, recorded their wound drainage status in a wound care app during 30 postoperative days. Risk factors for wound drainage were identified. Moderate to heavy wound leakage in the third postoperative week was strongly associated with the occurrence of PJI.

Despite the success of total hip replacements, there is still a devastating complication that orthopedic surgeons must deal with: periprosthetic infection. We conducted a retrospective study on patients diagnosed with chronic periprosthetic hip infection treated with a two-stage revision using a gentamicin-impregnated articulating cement spacer. We observed a had a high overall success rate (above 90%) and that there were no significant differences between mono- and polymicrobial infections.

In a first evaluation, the accuracy of a novel multiplex PCR (polymerase chain reaction) panel for rapid detection of pathogens in patients with a clinical suspicion of acute septic arthritis of native and prosthetic joints is assessed. Clear benefit is seen in patients with a suspected native septic arthritis and late acute prosthetic joint infection. This indicates that the panel allows for fast tailoring of antibiotics and may prompt the surgeon for surgical lavage in doubtful clinical cases.

We present the first published case of bilateral extensor tenosynovitis caused by Coxiella burnetii. C. burnetii should be considered in patients with inflammatory osteoarticular disease, including tenosynovitis, when conventional cultures are negative especially in elderly, male, or immunocompromised patients with exposure to animals.

Management of septic arthritis in native joints (SANJO) is often conducted by clinicians of different specialties, experience levels, and at all hours of the day. The SANJO guideline group makes evidence-based recommendations for diagnosis, microbiological investigation, initial surgery, empirical antibiotic treatment, early mobilization, evaluation of outcomes, and treatment failure. Special considerations were made for children, tuberculosis, and SANJO after cruciate ligament reconstruction.

Currently, there is no method available to reload antibiotic carriers to treat late bone infections or to prevent bacterial attachment. We propose a novel method to load and protect a biphasic calcium sulfate/hydroxyapatite (CaS/HA) carrier material from bacterial re-population by systemically administering a clinical dose of HA-seeking antibiotic rifampicin (RIF). CaS/HA-based carriers could recruit HA-seeking RIF to locally exert an adequate antibacterial effect at the targeted tissue.

Tuberculosis is a serious public health problem. A retrospective study of a series of cases of patients with a diagnosis of osteoarticular tuberculosis was carried out from 2014 to 2019. A total of 30 patients were confirmed. The presence of sequelae was correlated with the presence of motor deficit at the beginning of treatment and the high value of C-reactive protein at the end of treatment. These results may contribute to a better understanding of this disease to reduce complications.

Pan-spine MRI is warranted in patients who require operative treatment for pyogenic spinal infection to evaluate for multifocal infection.

Our multicentre study on a lower-limb osteosynthesis-associated infection (OAI) cohort by multidrug (MDR) and extensively drug (XDR) resistant Gram-negative bacteria found the following: implant retention with debridement was mostly performed in early OAI; 50.9 % of patients achieved remission of infection; remission reached 50 % (MDR) vs. 25 % (XDR) in early OAI and 60 % (MDR) vs. 44.4 % (XDR) in late OAI; age (> 60) and multiple surgeries were independent factors influencing lack of remission.

The scientific publication score (SPS) summarizes specific publication results. It is organized into five levels (1–5) based on evidence, data and statistical criteria. In risk factors for prosthetic joint infections, the highest scores were noted for anemia, malignancy and previous alloarthroplasty; for diagnosis methods, these were obtained for aspirate leucocyte count, neutrophils over 80 and interleukin-6 level. SPS is a promising new tool for automatic data mining and systematic reviews.