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.

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 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.

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.

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.

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.

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. 

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.

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.

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.

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.