Many studies evaluating infection tests after joint replacement focus only on patients who have surgery, but not all painful joints are operated on. This can lead to biased results. Our comment highlights this issue and suggests that including patients who do not have surgery but are monitored over time can give a clearer picture. This helps ensure that infection tests are more accurate when used in everyday medical practice, not just in surgical cases.

Our results indicate that certain parameters such as diabetes, low albumin levels, and prolonged duration of surgery are associated with a higher risk of infection in patients undergoing musculoskeletal tumor resection and megaprosthetic reconstruction. Strategies targeted towards glycemic control and nutritional status optimization are of great significance, while parameters that can affect the operating time can also have a positive impact on periprosthetic joint infection prevention.

This review assessed the effectiveness of single- and two-stage procedures for treating long-bone fracture-related infections, focusing on unhealed fractures without critical-sized bone defects. A total of 35 studies with 985 patients showed bone-healing rates of 80% for single-stage procedures and 77% for two-stage procedures. Infection eradication rates were 87% for single-stage approaches and 81% for two-stage approaches. The current evidence is inconclusive and lacks sufficient data to favor either approach.

Serum C-reactive protein, fibrinogen, and interleukin-6 show the best performance among serum markers for diagnosing periprosthetic joint infection (PJI), but they lack sufficient accuracy to confirm or exclude infection reliably. These markers should be re-evaluated in future PJI definitions, as they are not suitable as stand-alone tests. Given their limitations and the superior diagnostic performance of synovial markers, the role of serum markers in PJI diagnosis should be reconsidered.

This study provides the largest available, multicenter estimate of chronic osteomyelitis incidence in the United States. Incidence was generally steady over time, although a slight reduction was noted during the COVID-19 pandemic.

We examined whether the way hip replacement is performed affects the types of bacteria that can cause early infection. By reviewing records of 187 patients who needed follow-up surgery due to infection, the researchers found that the surgical technique did not influence which bacteria were present. They also found that body weight had no effect. These results suggest that newer, less invasive surgical methods as the direct anterior approach do not increase infection risks from specific bacteria.

The Musculoskeletal Infection Society (MSIS) and the European Bone and Joint Infection Society (EBJIS) are comprised of experts in preventing, diagnosing, and managing orthopedic infections. In 2023, MSIS and EBJIS surveyed their membership about their approach to various clinical aspects of these challenging conditions. The results indicate that, even among experts, there remains substantial variability of practice. This variability reflects open questions in the field. 

We assessed whether two debated scoring tools, KLIC and CRIME-80, could predict the failure of a treatment called debridement, antibiotics, and implant retention (DAIR) in prosthetic joint infections. We reviewed data from 102 patients. Neither score reliably predicted failure, even when the treatment was repeated. Our results highlight the limited clinical utility of these scores and support the need for better tools to guide treatment decisions in joint infections.

Guidelines currently recommend magnetic resonance imaging as a preferred imaging modality in the diagnosis of diabetic foot osteomyelitis.  We have found that among histologically confirmed cases the positive predictive value of the test is low, questioning its role in disease confirmation.  Additionally, we have found that the majority of cases of diabetic foot osteomyelitis can be successfully treated medically, even amongst histologically confirmed cases.