Articles | Volume 11, issue 1
https://doi.org/10.5194/jbji-11-31-2026
© Author(s) 2026. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-11-31-2026
© Author(s) 2026. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
The proportion of chronic periprosthetic joint infection patients with Candida isolates
Samuelson E. Osifo
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
Adrian Santana
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
Michael F. Shannon
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
Victoria R. Wong
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
Caroline F. Tyndall
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
Christian Cisneros
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
Niosha Parvizi
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
Brian A. Klatt
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
Johannes F. Plate
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
Nicolas S. Piuzzi
Cleveland Clinic Foundation, Cleveland, OH 44195, USA
Arthritis and Arthroplasty Design Group, The Bone and Joint Center, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA 15212, USA
Department of Orthopaedic Surgery, Department of Bioengineering, and Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Michael F. Shannon, Timothy Edwards, Timothy Maurer, Andrew J. Frear, Victoria R. Wong, Shaan Sadhwani, Clair Smith, Anthony Kamson, Brian Omslaer, Christian Cisneros, Andrew Gordon, Akeem Williams, Neel B. Shah, and Kenneth L. Urish
J. Bone Joint Infect., 10, 243–253, https://doi.org/10.5194/jbji-10-243-2025, https://doi.org/10.5194/jbji-10-243-2025, 2025
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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.
Andrew J. Frear, Michael F. Shannon, Shaan Sadhwani, Anthony O. Kamson, Clair Smith, Charity G. Patterson, Victoria R. Wong, Frank Johannes Plate, and Kenneth L. Urish
J. Bone Joint Infect., 10, 225–235, https://doi.org/10.5194/jbji-10-225-2025, https://doi.org/10.5194/jbji-10-225-2025, 2025
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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.
Anabelle Visperas, Daniel Santana, Minseon Ju, Nathalie B. Milbrandt, Yu Hsin Tsai, Sameera Wickramasinghe, Alison K. Klika, Nicolas S. Piuzzi, Anna Cristina S. Samia, and Carlos A. Higuera-Rueda
J. Bone Joint Infect., 7, 91–99, https://doi.org/10.5194/jbji-7-91-2022, https://doi.org/10.5194/jbji-7-91-2022, 2022
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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).
Xinyu Qi, Kimberly M. Brothers, Dongzhu Ma, Jonathan B. Mandell, Niles P. Donegan, Ambrose L. Cheung, Anthony R. Richardson, and Kenneth L. Urish
J. Bone Joint Infect., 6, 241–253, https://doi.org/10.5194/jbji-6-241-2021, https://doi.org/10.5194/jbji-6-241-2021, 2021
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Periprosthetic joint infection (PJI) is one of the most challenging complications following total joint arthroplasty. PJI infections are primarily caused by antibiotic-tolerant biofilms on the surface of the implant. Bacterial toxin antitoxin systems are believed to play a critical role in biofilm antibiotic tolerance and resistance. The objective of this study was to identify the role of the S. aureus toxin YoeB in biofilm formation, antibiotic susceptibility, and virulence.
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Short summary
Fungal organisms are conventionally estimated to account for 1 % –2 % of periprosthetic joint infection (PJI) cases, although diagnostic and reporting limitations may result in systematic underestimation. Using a quantitative missing-data sensitivity analysis across 23 studies encompassing 28 253 PJI cases, we estimated an adjusted Candida PJI proportion of approximately 5 %, increasing to nearly 10 % in chronic or refractory infections.
Fungal organisms are conventionally estimated to account for 1 % –2 % of periprosthetic joint...