This study aims to identify characteristics associated with septic arthritis in patients who have inconclusive laboratory findings. This would potentially allow for improved ability to identify a pathology that can be marked by ambiguity.  

We found three characteristics associated with increased risk of septic arthritis. Additionally, we found that lowering historic thresholds may be appropriate in order to prevent missed or delayed diagnosis of a pathology with considerable morbidity.

This systematic review evaluates debridement, antibiotic pearls and implant retention (DAPR) as a treatment option for acute periprosthetic joint infection. Analysis of available clinical studies shows encouraging infection control rates with few complications, suggesting that this approach may help to preserve implants in selected patients. However, current evidence is limited, and larger well-designed studies are needed to confirm its effectiveness and clarify its role in clinical practice.

This study examined how people with difficult joint infections manage long-term antibiotic treatment when the infection cannot be fully removed. We followed patients to record side effects and overall well-being. Many had stomach or skin problems, but most continued treatment. The results show that attentive follow-up and personalised care keep this therapy manageable and may guide better support in practice.

CarboCell is an injectable material designed to release antibiotics directly where bone infections occur. We tested it in animals and found that it delivered high and long-lasting drug levels in bone while keeping drug levels in the rest of the body very low. This suggests that CarboCell may improve infection treatment and reduce the need for whole-body antibiotic therapy.

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.

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.

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.

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.

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.

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.

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.

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. 

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.

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.

This study examined thousands of joint fluid samples to understand which bacteria cause infections in natural and artificial joints. Staphylococci were the main culprits, and antibiotic resistance increased over time, especially in methicillin-resistant and beta-lactamase-producing strains. Testing joint fluids in blood culture bottles improved detection, helping doctors to choose more effective treatments and protect joint health.

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.

Pseudomonas aeruginosa is a common pathogen in Gram-negative periprosthetic joint infections (PJIs). It is resistant to many antibiotics and forms biofilm, making it difficult to treat. We analyzed 1286 patients who underwent 1640 surgeries; among them, 38 patients with 50 procedures had P. aeruginosa. Most infections were chronic, often in hip revisions, with a high failure rate and recurrence. Due to its clinical and microbiological features, P. aeruginosa-related PJIs remain challenging.

Although local antibiotic administration is used to prevent and treat fracture-related infections, concerns remain about systemic absorption and potential renal toxicity. This study assessed serum levels and renal function after local gentamicin or vancomycin use. Gentamicin exceeded the lower limit of quantification in 17% of cases but remained below toxic levels. Vancomycin was undetectable. These findings suggest that local antibiotic administration does not harm renal function.

Periprosthetic joint infection (PJI) patient care has both positive and negative impacts on caregivers: (1) conflicts regarding the hospital stay, (2) novel personal challenges, (3) nursing, (4) emotional and psychological consequences, and (5) effects on the relationship. To conclude, caregivers of PJI patients shoulder a relevant burden both physically and emotionally, which seems to be very similar to caregivers of cancer patients. An inclusion in established treatment algorithms for PJI should be considered.