This retrospective study analyzed 682 patients who underwent primary total hip or knee arthroplasty to evaluate the impact of malnutrition on post-operative outcomes. Malnutrition, as defined by the Nutritional Risk Screening 2002 (NRS-2002) and controlling nutritional status (CONUT) scores, was significantly associated with higher rates of post-operative infection and poorer quality-of-life scores. Early nutritional assessment may improve post-operative recovery and reduce complication rates.

Timely and accurate pathogen identification is essential for managing periprosthetic joint infections (PJIs), yet conventional culturing often yields false negatives and requires prolonged incubation. We evaluated an in-vivo-like synovial fluid medium and isothermal microcalorimetry. The combined use of these approaches improved detection rates and reduced time to diagnosis, offering valuable insights to advance PJI diagnostics and support better clinical decision-making.

The aim of this proof-of-concept study was to investigate host immune gene expression through transcriptome profiling in patients with fracture-related infection and to explore the feasibility of detecting 16S rRNA and biofilm-associated genes, an approach not previously applied using this method. This technique revealed distinct immune activation patterns in fracture-related infection (FRI) and enabled the identification of pathogens that were missed by conventional culture techniques. 

Septic arthritis is a dangerous joint infection that requires rapid treatment. We analysed patient data to test common blood and synovial fluid markers and a newly developed composite score combining these markers. The score demonstrated higher sensitivity than individual tests alone within this dataset. Prospective validation in larger cohorts is required before clinical application.

Disseminated Mycobacterium abscessus infection is a rare clinical presentation that is challenging to treat due to the limited number of therapeutic options available. This complex case involved multi-speciality input across two hospitals. In the absence of guidelines for the management of extra-pulmonary and disseminated disease, our case  highlights which pharmacological agents were used and how surgery was utilised to achieve source control.

Segmental bone loss remains a major challenge, often worsened by fracture-related infection (FRI). Surgical debridement and tissue cultures are key initial steps. Bone transport, utilizing distraction osteogenesis, remains a key therapeutic strategy. Innovations like integrated fixation and motorized nails reduce patient morbidity. Management relies on a multidisciplinary approach. This review explores current and emerging concepts in the field of bone transport, focusing on FRI.

This article outlines 20 common errors in the prevention, diagnosis, and management of fracture-related infection (FRI), highlighting their clinical consequences and providing practical recommendations for avoiding them. By addressing typical pitfalls and emphasizing standardized procedures and interdisciplinary collaboration, the article aims to improve patient safety and treatment outcomes.

Early postoperative orthopaedic infections require rapid empirical antibiotic treatment, but the optimal regimen may differ by anatomical site. In this retrospective cohort study, empirical coverage was evaluated across anatomical sites. Vancomycin combined with ceftriaxone provided high coverage for most sites, while foot and ankle infections showed higher rates of resistant Gram-negative bacteria. These findings support an anatomy-specific approach to treatment.

We studied hip and knee prosthetic joint infections  caused by Staphylococcus epidermidis, a common pathogen that can form biofilm on implants. We reviewed over 100 cases to understand how antibiotic resistance affects treatment success. We found that infections resistant to rifampin, levofloxacin, or multiple antibiotics showed a higher failure rate. These findings may help surgeons choose the best surgical and antibiotic treatment approach for patients.

Synovial pH, lactate, and glucose are established biomarkers for joint infection but are usually analyzed in central laboratories. In this prospective analytical agreement study, we evaluated whether blood gas analyzers can measure these parameters at the point of care. Blood gas analyzer measurements showed good to excellent agreement with laboratory reference methods, particularly for lactate and glucose, supporting their use for rapid diagnosis of native and periprosthetic joint infection.