Articles | Volume 8, issue 1
https://doi.org/10.5194/jbji-8-29-2023
© Author(s) 2023. 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-8-29-2023
© Author(s) 2023. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Guidelines/recommendations/consensus paper
| 
12 Jan 2023
Guidelines/recommendations/consensus paper |
| 12 Jan 2023
| 12 Jan 2023
Guideline for management of septic arthritis in native joints (SANJO)
Dept. of Orthopaedic Surgery and Traumatology, Aarhus University
Hospital, Aarhus, Denmark
Members of the Steering Committee for the EBJIS Guideline Project on SANJO
Jeroen Neyt
CORRESPONDING AUTHOR
Dept. of Orthopedic Surgery, University Hospitals Ghent, Ghent, Belgium
Members of the Steering Committee for the EBJIS Guideline Project on SANJO
Natividad Benito
Dept. of Infectious Diseases, Hospital de la Santa Creu i Sant Pau,
Barcelona, Spain
Members of the Steering Committee for the EBJIS Guideline Project on SANJO
Miguel Araújo Abreu
Dept. of Infectious Diseases, Centro Hospitalar do Porto, Porto, Portugal
Yvonne Achermann
Dept. of Internal Medicine, Hospital Zollikerberg, Zürich, Switzerland
Svetlana Bozhkova
Dept. of Prevention and Treatment of Wound Infection, Vreden National Medical Research Center of Traumatology and Orthopedics, St. Petersburg, Russia
Liselotte Coorevits
Dept. of Clinical Microbiology, University Hospitals Ghent, Ghent, Belgium
Matteo Carlo Ferrari
Dept. of Internal Medicine, IRCCS Ospedale Galeazzi Sant'Ambrogio,
Milano, Italy
Karianne Wiger Gammelsrud
Dept. of Clinical Microbiology, University Hospital Oslo, Oslo, Norway
Ulf-Joachim Gerlach
Dept. of Septic Orthopedic Surgery and Traumatology, BG Klinikum
Hamburg, Hamburg, Germany
Efthymia Giannitsioti
Dept. of Infectious Diseases, Attikon University General Hospital,
Athens, Greece
Martin Gottliebsen
Dept. of Orthopaedic Surgery and Traumatology, Aarhus University
Hospital, Aarhus, Denmark
Nis Pedersen Jørgensen
Dept. of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
Tomislav Madjarevic
Dept. of Orthopaedic Surgery Lovran, University of Rijeka, Rijeka, Croatia
Leonard Marais
Dept. of Orthopaedic Surgery, University of KwaZulu-Natal, Durban, South Africa
Aditya Menon
Dept. of Orthopaedics, P.D. Hinduja Hospital and Medical Research
Centre, Mumbai, India
Dirk Jan Moojen
Dept. of Orthopaedic and Trauma Surgery, OLVG Amsterdam, Amsterdam, the Netherlands
Markus Pääkkönen
Dept. of Orthopaedics and Traumatology, Turku University Hospital,
Turku, Finland
Marko Pokorn
Dept. of Infectious Diseases, Ljubjana University Medical Center,
Ljubjana, Slovenia
Daniel Pérez-Prieto
Dept. of Orthopaedic Surgery and Traumatology, Hospital del Mar,
Barcelona, Spain
Nora Renz
Dept. of Infectious Diseases, Bern University Hospital, Bern, Switzerland
Jesús Saavedra-Lozano
Dept. of Pediatric Infectious Diseases Unit, Gregorio Marañón
Hospital, Madrid, Spain
Marta Sabater-Martos
Dept. of Orthopaedic Surgery and Traumatology, Hospital Clínic,
Barcelona, Spain
Parham Sendi
Dept. of Infectious Diseases, University Hospital of Basel, Basel, Switzerland
Institute for Infectious Diseases, University of Bern, Bern, Switzerland
Staffan Tevell
Dept. of Infectious Diseases, Karlstad Hospital and Centre for Clinical
Research, Karlstad, Sweden
Charles Vogely
Dept. of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, the
Netherlands
Members of the Steering Committee for the EBJIS Guideline Project on SANJO
Alex Soriano
Dept. of Infectious Diseases, Hospital Clínic, Barcelona, Spain
Members of the Steering Committee for the EBJIS Guideline Project on SANJO
A full list of authors appears at the end of the paper.
Editorial note: The supplement to this article was adjusted on 2 February 2023. The section "Workshop report 7" was shortened.
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Laura Bessems, Jolien Onsea, Marjan Wouthuyzen-Bakker, Irene K. Sigmund, Tristan Ferry, Richard Kuehl, Martin Clauss, Alex Soriano, Ricardo Sousa, Annette Schuermans, and Willem-Jan Metsemakers
J. Bone Joint Infect., 11, 489–492, https://doi.org/10.5194/jbji-11-489-2026, https://doi.org/10.5194/jbji-11-489-2026, 2026
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We examined whether patients with musculoskeletal infections need to be separated in hospital. A review of published studies found no support for routine isolation or dedicated wards for infections without multidrug-resistant organisms when standard precautions are applied. An international survey showed wide variation in clinician attitudes. These findings highlight a gap between evidence and perception and support a more risk-based approach.
Guido Bocchino, Giulio Maccauro, Andrea Zampoli, Rocco Papalia, Pier Francesco Indelli, Daniel Pérez-Prieto, and Javad Parvizi
J. Bone Joint Infect., 11, 479–488, https://doi.org/10.5194/jbji-11-479-2026, https://doi.org/10.5194/jbji-11-479-2026, 2026
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The current umbrella review showed that prevalence, diagnostic performance of adjunctive molecular methods, treatment strategies, and outcomes vary substantially. Molecular diagnostics appear to be promising as adjunctive tools in selected cases, but their interpretation requires caution, and they do not resolve all uncertainties related to culture-negative periprosthetic joint infections.
Loïc Fonkoué, Elizabeth K. Tissingh, Leonard C. Marais, Mbonisi Malaba, Kidanemariam Abrha, Jamie Ferguson, Mario Morgenstern, Olivier Cornu, Maritz Laubscher, Randy Buzisa Mbuku, George W. Galiwango, Matthijs Botman, Justyna Wojno, Mtebe Venance Majigo, Claude Martin Jr., William James Harrison, Alexander Thomas Schade, Kebba Marenah, Malvern Nyamutora, Phiona E. Namale, Vuyisa Mdingi, and Martin McNally
J. Bone Joint Infect., 11, 401–411, https://doi.org/10.5194/jbji-11-401-2026, https://doi.org/10.5194/jbji-11-401-2026, 2026
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Fracture-related infection is a serious problem after broken bones, especially in low-resource settings where specialist care and services are limited. An international expert group developed practical recommendations adapted to these realities. The guidance focuses on early fracture care, simple diagnostic approaches, flexible antibiotic use, affordable local treatments, good soft tissue management, and teamwork, aiming to improve safe and effective care in resource-limited environments.
Ernest Famada Arboix, Arnaud Fischbacher, Matteo Carlo Maria Ferrari, Olivier Borens, and Daniel Pérez-Prieto
J. Bone Joint Infect., 11, 355–361, https://doi.org/10.5194/jbji-11-355-2026, https://doi.org/10.5194/jbji-11-355-2026, 2026
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Gram-negative prosthetic joint infections are challenging. Robust European multicentre data remain limited. This study provides contemporary epidemiological and microbiological data from three tertiary centers across three European countries. We identify patient risk profiles and pathogen-related differences in treatment success. These findings offer novel, practical evidence to guide individualized management of gram-negative prosthetic joint infection (PJI).
Sander Bruyninckx, Stijn Ghijselings, Melissa Depypere, Alex Soriano, Willem-Jan Metsemakers, and Georges Vles
J. Bone Joint Infect., 11, 207–217, https://doi.org/10.5194/jbji-11-207-2026, https://doi.org/10.5194/jbji-11-207-2026, 2026
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When infection around an artificial hip or knee is suspected, joint fluid sampling is essential but often unsuccessful. We performed a systematic review to evaluate whether rinsing the joint with sterile salt water after an unsuccessful attempt improves diagnosis. Our findings show that this approach is safe, yields testable fluid in nearly all cases, and identifies infection in about one in five patients that would otherwise be missed.
Amber De Bleeckere, Jeroen Neyt, Jasper Van Heuverswyn, Stien Vandendriessche, Hannelore Hamerlinck, Annelynn Wallaert, Christophe Pattyn, Bruno Verhasselt, Jerina Boelens, and Tom Coenye
J. Bone Joint Infect., 11, 149–160, https://doi.org/10.5194/jbji-11-149-2026, https://doi.org/10.5194/jbji-11-149-2026, 2026
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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.
Christian Merz, Jan Klaas, Rik Osinga, Parham Sendi, Richard Alexander Kuehl, Mario Morgenstern, and Martin Clauss
J. Bone Joint Infect., 11, 113–121, https://doi.org/10.5194/jbji-11-113-2026, https://doi.org/10.5194/jbji-11-113-2026, 2026
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Founded in 2019, the Center for Musculoskeletal Infections at University Hospital Basel was established to implement standardized, multidisciplinary care for orthopaedic and trauma-related infections. This retrospective analysis of hip and knee periprosthetic joint infections (2019–2022) illustrates the feasibility and effectiveness of this structured approach, with infection control achieved in the majority of patients despite case complexity.
Ernesto Muñoz-Mahamud, Melissa Rivera, Ana Belén Larque, Laura Morata, Andrés Combalia, Alfonso Alías, Jenaro Ángel Fernández-Valencia, and Álex Soriano
J. Bone Joint Infect., 11, 43–52, https://doi.org/10.5194/jbji-11-43-2026, https://doi.org/10.5194/jbji-11-43-2026, 2026
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Several factors have been linked to failure in chronic prosthetic joint infection revisions. We hypothesize that osteomyelitis in septic hip revisions is underestimated and may significantly impact outcomes. In this series, 30.8 % of septic revisions exhibited bone samples consistent with osteitis, mainly associated with prolonged unsuccessful surgical and antibiotic treatments, the presence of a sinus tract, and subsequent failure after implant removal.
Benjamin R. Paul, David G. Deckey, Alex Soriano, Andy Miller, and Thorsten M. Seyler
J. Bone Joint Infect., 10, 525–541, https://doi.org/10.5194/jbji-10-525-2025, https://doi.org/10.5194/jbji-10-525-2025, 2025
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A total of 51 studies were reviewed to compare the alpha-defensin enzyme-linked immunosorbent assay (ELISA) and the lateral flow test for diagnosing joint replacement infections. Both tests are highly specific and accurately confirm infection, but ELISA showed greater sensitivity (87.8 % vs. 81.8 %), making it better for detection. These findings support the continued use of ELISA as the preferred diagnostic method.
Laura Bessems, Jolien Onsea, Baixing Chen, Marjan Wouthuyzen-Bakker, Irene K. Sigmund, Tristan Ferry, Richard Kuehl, Martin Clauss, Alex Soriano, Ricardo Sousa, Annette Schuermans, and Willem-Jan Metsemakers
J. Bone Joint Infect., 10, 489–500, https://doi.org/10.5194/jbji-10-489-2025, https://doi.org/10.5194/jbji-10-489-2025, 2025
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Isolation of patients with musculoskeletal infections in orthopedic care is controversial. Evidence supports selective isolation for certain resistant pathogens but not for non-resistant pathogens, nor does it support the routine use of septic wards. Effective infection control depends on hospital-wide strategies and adherence to standard precautions, with specialized centres offering better care than dedicated isolation units.
Irene K. Sigmund, Matthew J. Dietz, Marta Sabater-Martos, Antony J. R. Palmer, Nicolas Cortés-Penfield, and the “Serum Marker Workgroup” for the Unified PJI Definition Taskforce
J. Bone Joint Infect., 10, 363–376, https://doi.org/10.5194/jbji-10-363-2025, https://doi.org/10.5194/jbji-10-363-2025, 2025
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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.
Marta Sabater-Martos, Laura Morata, Josep Maria Segur, Alex Soriano, and Juan Carlos Martínez-Pastor
J. Bone Joint Infect., 10, 237–241, https://doi.org/10.5194/jbji-10-237-2025, https://doi.org/10.5194/jbji-10-237-2025, 2025
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This study's aim was to analyse the healing and failure rates of one-stage knee replacement in patients with positive and negative preoperative cultures and sinus presence. We concluded that culture-negative infections or the presence of a sinus tract showed similar results compared to patients that had undergone the same procedure with positive cultures or spared soft tissue.
Hendrika M. Schenk, Marine Sebillotte, Jose Lomas, Adrian Taylor, Eva Benavent, Oscar Murillo, Marta Fernandez-Sampedro, Kaisa Huotari, Craig Aboltins, Rihard Trebse, Alex Soriano, Marjan Wouthuyzen-Bakker, and on behalf of the ESCMID Study Group on Implant Associated Infections (ESGIAI)
J. Bone Joint Infect., 10, 217–224, https://doi.org/10.5194/jbji-10-217-2025, https://doi.org/10.5194/jbji-10-217-2025, 2025
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Patients with rheumatoid arthritis have a high treatment failure rate when faced with a late acute periprosthetic joint infection. Because of the rarity of the condition, we performed a multicenter case-control study. We identified predictors of treatment failure to ultimately improve the treatment outcome. Exchange of modular components seems important in this patient group, likely due to a higher rate of positive blood cultures compared to control patients.
Marta Sabater-Martos, Martin Clauss, Ana Ribau, Ricardo Sousa, and on behalf of the Leukocyte Count Synovial Fluid working group for the Unified PJI definition task force
J. Bone Joint Infect., 10, 165–184, https://doi.org/10.5194/jbji-10-165-2025, https://doi.org/10.5194/jbji-10-165-2025, 2025
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This meta-analysis evaluates synovial fluid white blood cell count and polymorphonuclear neutrophil proportion in order to diagnose chronic peri-prosthetic joint infection. Based on 74 studies, it identifies optimal thresholds, with rule-in and rule-out thresholds enhancing diagnostic precision. Confounding factors such as fractures and inflammatory arthritis are addressed. The findings support standardized diagnostic frameworks in improving accuracy and clinical consistency.
Irene K. Sigmund, Marjan Wouthuyzen-Bakker, Tristan Ferry, Willem-Jan Metsemakers, Martin Clauss, Alex Soriano, Rihard Trebse, and Ricardo Sousa
J. Bone Joint Infect., 10, 139–142, https://doi.org/10.5194/jbji-10-139-2025, https://doi.org/10.5194/jbji-10-139-2025, 2025
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This is a summary of our position paper on debridement, antimicrobial therapy, and implant retention (DAIR) procedures as a curative treatment strategy for acute periprosthetic hip and knee infections. It includes the defined indications as well as the contraindications of DAIR procedures when eradication/cure is intended, based on the currently available literature.
Irene K. Sigmund, Tristan Ferry, Ricardo Sousa, Alex Soriano, Willem-Jan Metsemakers, Martin Clauss, Rihard Trebse, and Marjan Wouthuyzen-Bakker
J. Bone Joint Infect., 10, 101–138, https://doi.org/10.5194/jbji-10-101-2025, https://doi.org/10.5194/jbji-10-101-2025, 2025
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In this paper, we discuss the most relevant factors influencing the outcome and define indications, contraindications, and risk factors of a DAIR procedure based on the currently available literature. Furthermore, we discuss the surgical technique in combination with systemic antimicrobial therapy in patients undergoing a DAIR procedure.
Tariq Azamgarhi, Simon Warren, Antonia Scobie, Natasha Karunaharan, Cristina Perez-Sanchez, Rebecca Houghton, Salma Hassan, Julie Lourtet-Hascoët, Hannah Kershaw, Parham Sendi, and Kordo Saeed
J. Bone Joint Infect., 10, 93–100, https://doi.org/10.5194/jbji-10-93-2025, https://doi.org/10.5194/jbji-10-93-2025, 2025
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This study evaluates dalbavancin, an antibiotic with a long duration of action, in treating complex bone and joint infections. It does not require daily dosing, allowing patients to leave the hospital earlier and reducing costs. Dalbavancin is shown to be effective and safe, especially for patients unsuitable for oral antibiotics or outpatient therapy, achieving similar results to traditional treatments while cutting healthcare costs.
Marta Sabater-Martos, Oscar Garcia, Laia Boadas, Laura Morata, Alex Soriano, and Juan Carlos Martínez-Pastor
J. Bone Joint Infect., 10, 41–49, https://doi.org/10.5194/jbji-10-41-2025, https://doi.org/10.5194/jbji-10-41-2025, 2025
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This is a retrospective diagnostic study in acute postoperative prosthetic joint infection in total knee arthroplasty that wants to determine diagnostic accuracy of synovial glucose and serum-to-synovial glucose ratio in acute postoperative infection. Both tests demonstrated good diagnostic potential. Notably, these biomarkers exhibited superior accuracy compared to the combination of C-reactive protein, synovial white blood cell count and polymorphonuclear percentage.
Laia Boadas-Gironès, Marta Sabater-Martos, Marc Ferrer-Banus, Àlex Soriano-Viladomiu, and Juan Carlos Martínez-Pastor
J. Bone Joint Infect., 9, 241–248, https://doi.org/10.5194/jbji-9-241-2024, https://doi.org/10.5194/jbji-9-241-2024, 2024
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When acute soft tissue defects are present after knee arthroplasty, the infection risk is high. A gastrocnemius flap is used for anterior defects, and it is not usually combined with debridement surgery unless infection is clear. We examined the benefit of combining coverage treatment with debridement surgery, DAIR, comparing the isolated traditional coverage treatment. The results suggested a higher healing rate in the combined treatment, so we recommended it.
Seung-Jae Yoon, Paul C. Jutte, Alex Soriano, Ricardo Sousa, Wierd P. Zijlstra, and Marjan Wouthuyzen-Bakker
J. Bone Joint Infect., 9, 231–239, https://doi.org/10.5194/jbji-9-231-2024, https://doi.org/10.5194/jbji-9-231-2024, 2024
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This study validated three models for predicting infection after hip and knee replacement surgery. By analyzing data from 2684 patients in the Netherlands, Portugal, and Spain, we found that the models developed by Tan, Del Toro, and Bülow effectively identified high-risk patients. These models can be used to enhance preoperative counseling and to tailor infection prevention measures individually, potentially improving outcomes and reducing healthcare costs.
Noémie Reinert, Katinka Wetzel, Fabian Franzeck, Mario Morgenstern, Markus Aschwanden, Thomas Wolff, Martin Clauss, and Parham Sendi
J. Bone Joint Infect., 9, 183–190, https://doi.org/10.5194/jbji-9-183-2024, https://doi.org/10.5194/jbji-9-183-2024, 2024
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We assessed concordance of in-house guidelines for diagnostic principles and antibiotic treatment duration (ABT) 2 years after their implementation. The goal was to standardize diagnostic and treatment principles: are we doing what we recommend? The adherence to recommendations in terms of biopsy sampling was good, moderate for histopathology and poor for anatomic labeling. In terms of ABT duration, the adherence was good, but further shortening for surgically cured cases is necessary.
Marta Sabater-Martos, Marc Ferrer, Laura Morata, Alex Soriano, and Juan Carlos Martínez-Pastor
J. Bone Joint Infect., 9, 17–26, https://doi.org/10.5194/jbji-9-17-2024, https://doi.org/10.5194/jbji-9-17-2024, 2024
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This is a meta-analysis of six studies describing the cutoff values of white blood cell count and polymorphonuclear percentage in synovial fluid for the diagnosis of acute postoperative peri-prosthetic joint infection (PJI).
We found that both the WBC count and PMN percentage are good markers for diagnosis of acute postoperative PJI. However, the synovial WBC count is more powerful in diagnosing acute postoperative PJI.
We found that both the WBC count and PMN percentage are good markers for diagnosis of acute postoperative PJI. However, the synovial WBC count is more powerful in diagnosing acute postoperative PJI.
Leonard C. Marais, Luan Nieuwoudt, Adisha Nansook, Aditya Menon, and Natividad Benito
J. Bone Joint Infect., 8, 189–207, https://doi.org/10.5194/jbji-8-189-2023, https://doi.org/10.5194/jbji-8-189-2023, 2023
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Tuberculosis (TB) primarily involves the lungs, but it may spread to other sites including joints. TB arthritis, is relatively rare, but it can result in severe damage to the joint and, ultimately, significant functional impairment. This article reviews the current literature on the topic and identifies key areas where further scientific research is needed to improve the diagnosis and management of the disease.
Sara Elisa Diniz, Ana Ribau, André Vinha, José Carlos Oliveira, Miguel Araújo Abreu, and Ricardo Sousa
J. Bone Joint Infect., 8, 109–118, https://doi.org/10.5194/jbji-8-109-2023, https://doi.org/10.5194/jbji-8-109-2023, 2023
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While there is no gold standard test to diagnose periprosthetic joint infection (PJI), we believe synovial fluid analysis, especially preoperatively, is a critical step in differentiating between infection and aseptic failure. Adding simple and inexpensive biomarkers such as synovial C-reactive protein (CRP) or adenosine deaminase (ADA) and combined interpretation can be helpful in the context of inconclusive results.
Efthymia Giannitsioti, Mauro José Salles, Andreas Mavrogenis, Dolors Rodriguez-Pardo, Ibai Los-Arcos, Alba Ribera, Javier Ariza, María Dolores del Toro, Sophie Nguyen, Eric Senneville, Eric Bonnet, Monica Chan, Maria Bruna Pasticci, Sabine Petersdorf, Natividad Benito, Nuala O' Connell, Antonio Blanco García, Gábor Skaliczki, Pierre Tattevin, Zeliha Kocak Tufan, Nikolaos Pantazis, Panayiotis D. Megaloikonomos, Panayiotis Papagelopoulos, Alejandro Soriano, Antonios Papadopoulos, and the ESGIAI collaborators study group
J. Bone Joint Infect., 7, 279–288, https://doi.org/10.5194/jbji-7-279-2022, https://doi.org/10.5194/jbji-7-279-2022, 2022
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Our multicentre study on a lower-limb osteosynthesis-associated infection (OAI) cohort by multidrug (MDR) and extensively drug (XDR) resistant Gram-negative bacteria found the following: implant retention with debridement was mostly performed in early OAI; 50.9 % of patients achieved remission of infection; remission reached 50 % (MDR) vs. 25 % (XDR) in early OAI and 60 % (MDR) vs. 44.4 % (XDR) in late OAI; age (> 60) and multiple surgeries were independent factors influencing lack of remission.
Ernesto Muñoz-Mahamud, Eduard Tornero, José A. Estrada, Jenaro A. Fernández-Valencia, Juan C. Martínez-Pastor, and Álex Soriano
J. Bone Joint Infect., 7, 109–115, https://doi.org/10.5194/jbji-7-109-2022, https://doi.org/10.5194/jbji-7-109-2022, 2022
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A patient with normal D-dimer value has a low risk of prosthetic joint infection, so serum D-dimer assessment should always be considered as a useful test to rule out chronic prosthetic joint infection (especially in those cases caused by low-virulence microorganisms in which conventional tests may lead to misdiagnosis). Conversely, the platelet count to mean platelet volume ratio may be of limited value for accurately diagnosing prosthetic joint infection.
Simon Martin Heinrich, Parham Sendi, and Martin Clauss
J. Bone Joint Infect., 6, 423–424, https://doi.org/10.5194/jbji-6-423-2021, https://doi.org/10.5194/jbji-6-423-2021, 2021
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We report on an 83-year-old woman who had an open removal of a baker's cyst several months after total knee arthroplasty. The following wound healing problem was first misinterpreted as being superficial. With an injection of methylene blue and a contrast medium, we showed the extent of the sinus tract, proving the periprosthetic joint infection.
Diana Salomi Ponraj, Thomas Falstie-Jensen, Nis Pedersen Jørgensen, Christen Ravn, Holger Brüggemann, and Jeppe Lange
J. Bone Joint Infect., 6, 367–378, https://doi.org/10.5194/jbji-6-367-2021, https://doi.org/10.5194/jbji-6-367-2021, 2021
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Implant-associated infections (IAIs) in orthopaedic surgery are associated with high morbidity and mortality. Slow-growing anaerobic bacteria are increasingly being recognized as potential causative agents in such infections, but their diagnosis is difficult. The purpose of this review is to summarize the current knowledge of IAIs with these bacteria. In particular, the review gives an overview of the current methodology in the diagnosis of such infections, to serve as a guide for clinicians.
Karel-Jan Dag François Lensen, Rosa Escudero-Sanchez, Javier Cobo, Rihard Trebše, Camelia Gubavu, Sara Tedeschi, Jose M. Lomas, Cedric Arvieux, Dolors Rodriguez-Pardo, Massimo Fantoni, Maria Jose Garcia Pais, Francisco Jover, Mauro José Costa Salles, Ignacio Sancho, Marta Fernandez Sampedro, Alex Soriano, Marjan Wouthuyzen-Bakker, and ESCMID Study Group of Implant Associated Infections (ESGIAI)
J. Bone Joint Infect., 6, 313–319, https://doi.org/10.5194/jbji-6-313-2021, https://doi.org/10.5194/jbji-6-313-2021, 2021
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Our data suggest that, in periprosthetic joint infection (PJI) patients with a draining sinus, suppressive antibiotic treatment (SAT) can be considered on an individual basis. SAT may reduce pain and favour the closure of the sinus tract in certain individuals, but the prescription of SAT does not appear to have any influence on the prevention of prosthetic loosening and other infectious complications.
André Dias Carvalho, Ana Ribau, Daniel Soares, Ana Claudia Santos, Miguel Abreu, and Ricardo Sousa
J. Bone Joint Infect., 6, 305–312, https://doi.org/10.5194/jbji-6-305-2021, https://doi.org/10.5194/jbji-6-305-2021, 2021
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When we initiated this paper, there was no evidence on what kind of spacers we should use. Our work was to prove that we must use a broad spectrum of antibiotics at the spacers in two-stage revision procedures. We demonstrate that a large spectrum of antibiotics at the spacer results in a lower rate of positive cultures during preimplantation and, subsequently, better outcomes and lower rate of infection.
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Short summary
Management of septic arthritis in native joints (SANJO) is often conducted by clinicians of different specialties, experience levels, and at all hours of the day. The SANJO guideline group makes evidence-based recommendations for diagnosis, microbiological investigation, initial surgery, empirical antibiotic treatment, early mobilization, evaluation of outcomes, and treatment failure. Special considerations were made for children, tuberculosis, and SANJO after cruciate ligament reconstruction.
Management of septic arthritis in native joints (SANJO) is often conducted by clinicians of...
