A multi-center study of 563 periprosthetic joint infections (PJIs) found that 16.5 % were culture negative. These patients more often had prior revision or PJI, longer symptom duration and fewer systemic signs. On multivariable analysis, symptom duration >12 weeks was the only independent risk factor (odds ratio 2.24). The findings support the fact that culture-negative infections present insidiously, informing diagnostic strategies.

This study explores a solution for patients who suffer a fracture-related infection of the talus following complex ankle injuries. We treated three patients using a two-stage procedure that removes the damaged bone and stabilizes the ankle with a retrograde nail and tantalum spacers. After 3 years, the results showed no relapse of infection, good alignment, and improved quality of life with minimal pain. This approach offers hope for challenging cases where treatment options are limited.