Articles | Volume 6, issue 7
https://doi.org/10.5194/jbji-6-257-2021
© Author(s) 2021. 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-6-257-2021
© Author(s) 2021. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Systematic review of risk prediction studies in bone and joint infection: are modifiable prognostic factors useful in predicting recurrence?
Centre for Statistics in Medicine, Nuffield Department of Orthopaedics,
Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University
Hospitals NHS Foundation Trust, Oxford, UK
Andrew Hotchen
Division of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital,
Cambridge University Hospitals, Cambridge, UK
Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University
Hospitals NHS Foundation Trust, Oxford, UK
Martin A. McNally
Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University
Hospitals NHS Foundation Trust, Oxford, UK
Jamie Hartmann-Boyce
Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health
Sciences, University of Oxford, Oxford, UK
Matthew Scarborough
Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University
Hospitals NHS Foundation Trust, Oxford, UK
Gary Collins
Centre for Statistics in Medicine, Nuffield Department of Orthopaedics,
Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
Related authors
No articles found.
Asanka Wijendra, Alex Ramsden, and Martin McNally
J. Bone Joint Infect., 8, 183–188, https://doi.org/10.5194/jbji-8-183-2023, https://doi.org/10.5194/jbji-8-183-2023, 2023
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Cancerous transformation is a rare but potentially life-threatening complication of chronic bone infection. As with all forms of cancer, early detection and diagnosis is crucial to outcome.
Whilst there have been over 100 cases of chronic bone infection with cancerous transformation reported in the literature between 1999 and 2020, this is the first case report to document transformation with 20 years of concordant imaging and clinical review.
Niels Vanvelk, Esther M. M. Van Lieshout, Jolien Onsea, Jonathan Sliepen, Geertje Govaert, Frank F. A. IJpma, Melissa Depypere, Jamie Ferguson, Martin McNally, William T. Obremskey, Charalampos Zalavras, Michael H. J. Verhofstad, and Willem-Jan Metsemakers
J. Bone Joint Infect., 8, 133–142, https://doi.org/10.5194/jbji-8-133-2023, https://doi.org/10.5194/jbji-8-133-2023, 2023
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This international retrospective cohort study displays the diagnostic characteristics of 609 patients who were treated for fracture-related infection (FRI). Clinical confirmatory criteria were present in 77% of patients. In the remaining patients, the decision to operatively collect deep tissue cultures had to be based on a set of suggestive criteria. The combined use of these suggestive criteria should guide treating physicians in the management pathway of FRI.
Martin McNally
J. Bone Joint Infect., 6, 199–201, https://doi.org/10.5194/jbji-6-199-2021, https://doi.org/10.5194/jbji-6-199-2021, 2021
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This paper provides further evidence that treatment of osteomyelitis by serial debridement without the use of local antimicrobials has high recurrence rates (20 %–30 %). The addition of bioglass did not improve this compared to using bone graft alone. Additional systemic antibiotic was required in many cases, increasing the risk of antimicrobial resistance. Recent series of single-stage surgery with local antibiotic delivery have reported better outcomes.
Jamie Ferguson, Myriam Alexander, Stuart Bruce, Matthew O'Connell, Sue Beecroft, and Martin McNally
J. Bone Joint Infect., 6, 151–163, https://doi.org/10.5194/jbji-6-151-2021, https://doi.org/10.5194/jbji-6-151-2021, 2021
Martina Galea Wismayer, Kurstein Sant, Ryan Giordmaina, and Martin McNally
J. Bone Joint Infect., 6, 141–145, https://doi.org/10.5194/jbji-6-141-2021, https://doi.org/10.5194/jbji-6-141-2021, 2021
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We report the treatment of bone infection in a patient with a rare disease which causes overgrowth of the limb. Careful assessment of the scans showed that the infection was in some new bone which had formed in the soft tissues after a minor injury to the leg and not in one of the major bones. This made treatment much easier with a successful outcome.
Max Mifsud, Jamie Y. Ferguson, David A. Stubbs, Alex J. Ramsden, and Martin A. McNally
J. Bone Joint Infect., 6, 63–72, https://doi.org/10.5194/jbji-6-63-2020, https://doi.org/10.5194/jbji-6-63-2020, 2020
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Chronic bone infections often present with major bone and soft tissue loss which can be difficult to manage. In this study, we treated the most complex infections using surgery which reconstructed all of the tissues in one operation.
We showed that this was a safe approach with very good outcomes. All of the bones healed and 96.5 % of patients were infection-free at final follow-up. This type of surgery requires close cooperation of a multidisciplinary team with expertise in major infections.
Related subject area
Subject: Risk factors for bone and joint infections | Topic: All topics
Emergence of rifampicin-resistant staphylococci on the skin and nose of rifampicin-treated patients with an orthopaedic-device-related infection
Should treatment decisions in septic arthritis of the native hip joint be based on the route of infection?
Wound drainage after arthroplasty and prediction of acute prosthetic joint infection: prospective data from a multicentre cohort study using a telemonitoring app
The unrelenting tide of osteoarticular infections in children: reflections from Uganda, eastern Africa
Arthroplasty after septic arthritis of the native hip and knee: retrospective analysis of 49 joints
The presence of a draining sinus is associated with failure of re-implantation during two-stage exchange arthroplasty
Immunological evaluation of patients with orthopedic infections: taking the Cierny–Mader classification to the next level
Bilateral septic arthritis with rapid progressive destruction of the femoral head after joint injection in rheumatoid arthritis
Alexandra Wallimann, Yvonne Achermann, Ciara Ferris, Mario Morgenstern, Martin Clauss, Vincent Stadelmann, Hannes Andreas Rüdiger, Liam O'Mahony, and Thomas Fintan Moriarty
J. Bone Joint Infect., 9, 191–196, https://doi.org/10.5194/jbji-9-191-2024, https://doi.org/10.5194/jbji-9-191-2024, 2024
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Skin commensal bacteria such as staphylococci are often the source of orthopaedic-device-related infections. Rifampicin is a widely used antibiotic in the treatment of these infections. The results of this study show that oral rifampicin therapy leads to a consistent and persistent induction of resistance in commensal staphylococci on the skin and in the nose for a prolonged time.
Fred Ruythooren, Stijn Ghijselings, Jordi Cools, Melissa Depypere, Paul De Munter, Willem-Jan Metsemakers, and Georges Vles
J. Bone Joint Infect., 8, 209–218, https://doi.org/10.5194/jbji-8-209-2023, https://doi.org/10.5194/jbji-8-209-2023, 2023
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A total of 41 patients who underwent surgical treatment for septic arthritis (SA) of the native hip were studied. We show that patients with SA of the native hip can be divided in three distinct clinical subgroups based on route of infection. Route of infection is directly related to the chance of femoral head preservation and should, therefore, be the basis for decision-making. Only patients with blood-borne infections in an undamaged hip had a reasonable chance of femoral head preservation.
Henk Scheper, Rachid Mahdad, Brenda Elzer, Claudia Löwik, Wierd Zijlstra, Taco Gosens, Joris C. T. van der Lugt, Robert J. P. van der Wal, Rudolf W. Poolman, Matthijs P. Somford, Paul C. Jutte, Pieter K. Bos, Richard E. Zwaan, Rob G. H. H. Nelissen, Leo G. Visser, Mark G. J. de Boer, and the wound care app study group
J. Bone Joint Infect., 8, 59–70, https://doi.org/10.5194/jbji-8-59-2023, https://doi.org/10.5194/jbji-8-59-2023, 2023
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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.
Antonio Loro
J. Bone Joint Infect., 7, 183–185, https://doi.org/10.5194/jbji-7-183-2022, https://doi.org/10.5194/jbji-7-183-2022, 2022
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Forty years ago I made a radical professional choice: to dedicate a few years of practice to the African continent. Not surprisingly, a few years became many. This paper is dedicated to the children who are battling osteoarticular infections and to those who will be struggling with them in future.
Elodie Portier, Valérie Zeller, Younes Kerroumi, Beate Heym, Simon Marmor, and Pascal Chazerain
J. Bone Joint Infect., 7, 81–90, https://doi.org/10.5194/jbji-7-81-2022, https://doi.org/10.5194/jbji-7-81-2022, 2022
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Arthroplasty after septic arthritis (SA) raises diagnostic and therapeutic questions. We report on 49 knee and hip arthroplasties following SA. Median SA-to-arthroplasty interval was 32 weeks, and one-stage arthroplasty was performed in 43 episodes. No SA relapse but 5 new prosthetic joint infections occurred with an infection-free survival rate of 96 % at 2 years. Arthroplasty may be a post-SA option, even within a short period of time but requires specific management and prolonged monitoring.
Alexandra S. Gabrielli, Alan E. Wilson, Richard A. Wawrose, Malcolm Dombrowski, Michael J. O'Malley, and Brian A. Klatt
J. Bone Joint Infect., 7, 55–60, https://doi.org/10.5194/jbji-7-55-2022, https://doi.org/10.5194/jbji-7-55-2022, 2022
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Prosthetic joint infection is a complicated problem, where reinfection can occur. Understanding risk factors for failure helps optimize care. This study investigated if the presence of a draining sinus tract was correlated with failure of two-stage revision. Previous cases were reviewed at our institution over a 10-year period. Patients with a sinus tract were significantly less likely to be replanted compared to those without a sinus tract at presentation.
Janet D. Conway, Vache Hambardzumyan, Nirav G. Patel, Shawn D. Giacobbe, and Martin G. Gesheff
J. Bone Joint Infect., 6, 433–441, https://doi.org/10.5194/jbji-6-433-2021, https://doi.org/10.5194/jbji-6-433-2021, 2021
Short summary
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Adding immunologic evaluation to the Cierny–Mader classification more accurately determines patients’ true host status and better quantifies risk and outcome with respect to orthopedic infection. Immunologically deficient A hosts should be quantified as B hosts. IgG deficiencies can be addressed with supplementation. IgG replacement should be considered in patients with recurrent orthopedic infections.
Viola Freigang, Florian Baumann, and Volker Alt
J. Bone Joint Infect., 6, 255–256, https://doi.org/10.5194/jbji-6-255-2021, https://doi.org/10.5194/jbji-6-255-2021, 2021
Short summary
Short summary
We report on a clinical case of rapid progressive destruction of the femoral head
after joint injection in rheumatoid arthritis.
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Short summary
Clinical prognostic models are tools that predict treatment outcomes for individual patients. For adults with bone and joint infection treated with surgery and implant removal, this review found no existing unbiased clinical prediction models that took modifiable health factors into account to estimate prognosis. Developing a clinical prognostic model may help treatment decisions and future targeted research in orthopaedic infection.
Clinical prognostic models are tools that predict treatment outcomes for individual patients....