Periprosthetic joint infection (PJI) is associated with increased morbidity and mortality but can be difficult to diagnose. Our aim is to analyse common diagnostic tests, specifically joint aspiration culture performed for suspected PJI by a single practitioner. We suggest that hip aspiration culture performs similarly to less invasive tests to rule out infection, recommend caution in interpreting a positive culture and suggest that hip aspiration should be used only with other synovial tests.

We describe the second known case of unifocal thoracic osteomyelitis due to Bartonella henselae, which presented as a thoracic tumor.

Osteomyelitis is commonly observed in the pediatric population across sub- Saharan Africa. This 44-patient case series presents vascularized fibula flap (VFF) as a viable option for reconstruction of post-osteomyelitis defects of pediatric long bones in low-income countries. VFF achieves good radiological and functional outcomes, although postoperative complications are common. There was no recurrence of the bone infection in any of our cases. Further prospective studies are needed.

Irrigation and debridement in the treatment of periprosthetic joint infection (PJI) serves an integral role in the eradication of bacterial burden and subsequent re-infection rates. Identifying the optimal irrigation agent, however, remains challenging, as there is limited data on superiority. Future clinical studies are needed to identify ideal irrigation solutions with optimal bactericidal properties and low cytotoxicity for PJI treatment.

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.

Non-typeable Haemophilus influenzae (NTHi) is here described for the first time as responsible for an invasive infection involving blood, vertebral and joint infection in a 79-year-old woman. It was triggered by an asymptomatic sinus condition. Surgical drainage and antibiotic therapy allowed recovery. This case shows that a full cartography of NTHi infection is unavoidable and may reveal unknown dissemination mechanisms.

Our objective was to analyze if patients with larger soft-tissue thickness measured in X-rays have greater risk of acute infection after hip arthroplasty. We reviewed acute-infection patients in our institution over 6 years and selected 2 patients with similar demographics that were not infected for each case. Larger measurements showed association with acute infection. This easily obtainable measurement might provide helpful data in making preoperative risk assessments and prevention programs.

Cutibacterium acnes infections in hip arthroplasty may be underdiagnosed. Cemented components in THA seem to protect from colonization of Cutibacterium acnes. Post-operative infections are preferably surgically treated with DAIR within a month after hip replacement but infection eradication may still not be excluded at an extended time in some cases. Further large-scale studies are needed to confirm our results.

Determining whether periprosthetic joint infections are acute or chronic can be a challenge for the arthroplasty surgeon. We present data that support the use of the ratio between the ESR and CRP in patients with PJI. Using this simple calculation of the ESR / CRP ratio, surgeons may have more confidence in determining whether an infection is acute or chronic, which can aid in treatment decisions.

We report an intriguing and challenging case of severe skin necrosis, in the setting of a periprosthetic knee infection, after the beginning of low-molecular-weight heparin. Our multidisciplinary approach and the results can be useful for other orthopaedic surgeons that may face a similar case.