https://jbji.copernicus.org/articles/ Recent articles of the journal Journal of Bone and Joint Infection en https://doi.org/10.5194/jbji-11-413-2026 Management and outcomes of culture-negative periprosthetic joint infection: a systematic review and meta-analysis Farzad Pourghazi, Seyed Mohammad Amin Alavi, Takahiro Matsuo, Georges Baaklini, Matthew P. Abdel, Aaron J. Tande, and Elie F. Berbari J. Bone Joint Infect., 11, 413–430, https://doi.org/10.5194/jbji-11-413-2026, 2026 Culture-negative periprosthetic joint infection (CN-PJI) remains a diagnostic and therapeutic challenge. In this systematic review and meta-analysis of 27 studies (1399 patients), pooled success was 83.6 %, failure was 17.2 %, and mortality was 2.4 %. Outcomes were better with exchange arthroplasty than debridement, antimicrobials, and implant retention (DAIR). Antibiotic regimens were heterogeneous. Overall, CN-PJI may have favorable outcomes, but standardized prospective studies are needed. Tue, 14 Jul 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-401-2026 Management of fracture-related infection in low-resource settings in Africa: recommendations and guidelines from an international expert group 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, 2026 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. Thu, 09 Jul 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-395-2026 Literature review and case report on the use of rezafungin for spondylodiscitis in an outpatient parenteral antimicrobial therapy (OPAT) setting Alexander J. Richards, Ammara Asif, Monica Ivan, Patrick J. Lillie, Gavin Barlow, and Chloe Walsh J. Bone Joint Infect., 11, 395–400, https://doi.org/10.5194/jbji-11-395-2026, 2026 Fungal infection can be difficult to treat, requiring long periods of hospitalisation. Rezafungin is a promising new antifungal medication that can be used to treat complex, deep-seated fungal infection. We examine the reported use of rezafungin in managing fungal infection of the bones and joints in an outpatient setting. Our case helps to provide further experience in the use of rezafungin as a powerful tool in helping patients get out of hospital and avoid further admissions. Mon, 06 Jul 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-387-2026 Changes in systemic immune–inflammation index predict periprosthetic joint infection after hemiarthroplasty in elderly patients Emre Bilgin, Onur Gultekin, Murat Kilic, Umit Burak Alparslan, Mehmet Berke Yusan, and Ahmet Onur Akpolat J. Bone Joint Infect., 11, 387–394, https://doi.org/10.5194/jbji-11-387-2026, 2026 We looked at whether routine blood tests could help identify patients at higher risk of infection after hip fracture surgery. Using data from a large group of older patients, we found that higher inflammation levels after surgery, especially when they increased compared to before surgery, were linked to a greater risk of infection. This suggests that simple and widely available tests may help clinicians recognize high-risk patients earlier and guide closer follow-up. Fri, 03 Jul 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-373-2026 Integrating molecular and conventional diagnostics in native vertebral osteomyelitis: a narrative review Farzad Pourghazi, Omar Mahmoud, Francesco Petri, Said El Zein, Gina A. Suh, Takahiro Matsuo, Andrea Gori, Audrey N. Schuetz, and Elie F. Berbari J. Bone Joint Infect., 11, 373–385, https://doi.org/10.5194/jbji-11-373-2026, 2026 Native vertebral osteomyelitis, a spinal bone infection, is difficult to diagnose, and delays can worsen outcomes. This review examines how traditional laboratory tests and newer genetic techniques can be integrated to improve identification of the responsible microorganism. We show that combining these approaches within the diagnostic pathway may increase accuracy and support earlier diagnosis, enabling more timely and informed treatment decisions. Mon, 29 Jun 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-363-2026 Neutrophil extracellular trap (NET)-related index as an indicator of periprosthetic joint infection Tingrun Cui, Yongjian Liang, Zeyu Feng, Libo Hao, Guoqiang Zhang, Ming Ni, Jing Sheng, Dihua Shangguan, Jiying Chen, and Jun Fu J. Bone Joint Infect., 11, 363–371, https://doi.org/10.5194/jbji-11-363-2026, 2026 Periprosthetic joint infection is the most challenging complication following arthroplasty. This study, utilizing clinically obtained synovial fluid specimens, confirmed the unique value of neutrophil extracellular traps and their constituent components in the diagnosis of periprosthetic joint infection, thereby enabling further precision in the diagnosis of periprosthetic joint infection and reducing the severe consequences associated with it. Mon, 22 Jun 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-355-2026 Gram-negative prosthetic joint infections: a retrospective multicentre European study of incidence, risk factors, and treatment outcomes 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, 2026 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). Fri, 19 Jun 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-343-2026 Intrawound vancomycin powder in orthopaedic surgery after the VPIP trial: a critical reappraisal of efficacy, dosing, application plane, and antimicrobial stewardship Felix Werneburg, Alexander Zeh, Natalia Gutteck, and Karl-Stefan Delank J. Bone Joint Infect., 11, 343–354, https://doi.org/10.5194/jbji-11-343-2026, 2026 For over a decade, orthopaedic surgeons have sprinkled vancomycin powder into surgical wounds to prevent infection. New large randomised trials show this is ineffective in hip and knee replacements, though possibly useful in high-risk fracture surgery and infected revision cases. Based on these findings and international guidelines, we propose a framework that identifies specifically in which operations this antibiotic powder may still have a role and in which it should be avoided. Fri, 12 Jun 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-337-2026 “ID-ing” the value: how are orthopaedic infectious disease physicians compensated for their time? A national survey Jessica C. O'Neil, Bethany Lehman, Thorsten Seyler, Nicolas Piuzzi, Sean Ryan, Jessica Seidelman, Julie Reznicek, and Poorani Sekar J. Bone Joint Infect., 11, 337–342, https://doi.org/10.5194/jbji-11-337-2026, 2026 We surveyed physicians in the United States who specialize in bone and joint infections to better understand how their work is financially supported. Most respondents reported spending substantial time on patient coordination, education, and multidisciplinary planning that was not directly reimbursed or protected by dedicated funding. These findings suggest current payment models may not adequately support the complex team-based care required for serious orthopedic infections. Fri, 12 Jun 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-331-2026 Primary hip or knee arthroplasty in the setting of chronic suppressive antibiotics for prior periprosthetic joint infection: a scoping review Vincent K. Melemai, Ryan J. Blake, Christian Barill, Adam E. Klein, Matthew J. Dietz, and Allison M. Lastinger J. Bone Joint Infect., 11, 331–336, https://doi.org/10.5194/jbji-11-331-2026, 2026 Total joint arthroplasty is increasingly common in the US, with an expected rise in periprosthetic joint infection (PJI). Limited evidence exists of PJI risk in new primary arthroplasty in patients on chronic suppression for prior PJI. Due to a lack of evidence examining this population, shared decision-making must be informed by medical comorbidities and patient-related risk factors, infectious history, and the current evidence of PJI treatment and infection control measures. Fri, 05 Jun 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-323-2026 High intra- and inter-observer reliability of the PJI-TNM classification in acute and chronic periprosthetic hip joint infection Dominic Simon, Jonas Tumler, Lennart M. Schroeder, Florian Pachmann, Eduardo Suero, Boris M. Holzapfel, Gautier Beckers, and Kathrin Pfahl J. Bone Joint Infect., 11, 323–330, https://doi.org/10.5194/jbji-11-323-2026, 2026 This study assessed the reliability of the tumor, node, and metastasis (TNM) classification for periprosthetic joint infection (PJI) in patients with acute and chronic infections after hip replacement. Using a large clinical cohort, we found that clinicians with different levels of experience applied the system consistently. These findings support its use for describing disease severity, improving communication, and supporting future research and treatment planning. Thu, 04 Jun 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-315-2026 Tapping our resources: do preoperative aspirations add diagnostic value in hip and knee periprosthetic joint infection? Anne Spichler-Moffarah, Lauren Daddi, Ilda Molloy, Tyler Luu, Duc Nguyen, and Marjorie Golden J. Bone Joint Infect., 11, 315–321, https://doi.org/10.5194/jbji-11-315-2026, 2026 This is a study that included our daily practice with a cohort of patients with prosthetic joint infection (PJI) of the knee or hip, that had admissions with concern for PJI, and had surgery for that. Synovial aspiration and cultures were compared with intraoperative culture results. Our concordance rate (yielding the same organism(s) or if both were negative) between synovial and intraoperative cultures was almost 75 %, with low frequency of culture-negative and few polymicrobial PJI.   Wed, 03 Jun 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-305-2026 Sinus tract and purulence as clinical criteria for periprosthetic joint infection: diagnostic accuracy, microorganisms, and clinical outcomes Markus Luger, Martin McNally, Lukas Rabitsch, Reinhard Windhager, Richard Lass, and Irene Katharina Sigmund J. Bone Joint Infect., 11, 305–313, https://doi.org/10.5194/jbji-11-305-2026, 2026 Sinus tracts communicating with the prosthesis demonstrated high specificity and support their use as a confirmatory criterion for periprosthetic joint infection (PJI). Purulence also showed high specificity but may be better considered to be a suggestive criterion due to challenges in clinical differentiation. Both findings were associated with distinct microbiological patterns and less favourable outcomes, highlighting their clinical relevance. Fri, 29 May 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-299-2026 Nasal decolonization in total joint arthroplasty: current state of evidence Andrea Zampoli, Ghazal Pourbozorg, Goksel Dikmen, Ibrahim Tuncay, and Javad Parvizi J. Bone Joint Infect., 11, 299–304, https://doi.org/10.5194/jbji-11-299-2026, 2026 Staphylococcus aureus nasal colonization is a key contributor to postoperative infection after hip and knee replacement. We review current evidence on screening and nasal decolonization, highlighting that reliable decolonization is more critical than screening alone. We summarize practical treatment options and propose a simple, standardized preoperative protocol that can be implemented in routine arthroplasty pathways to reduce preventable infections. Fri, 22 May 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-287-2026 Can we identify which patients are likely to have septic arthritis with borderline synovial fluid cell counts? Boshen Liu, Michael Raffetto, Eric J. Abbenhaus, Gavin S. Hautala, William R. Taylor, Lucy Bowers, and Paul Edward Matuszewski J. Bone Joint Infect., 11, 287–297, https://doi.org/10.5194/jbji-11-287-2026, 2026 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. Tue, 19 May 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-277-2026 The use of debridement, antibiotic pearls, and implant retention (DAPRI) in the management of acute periprosthetic joint infections: a systematic review Doriana Di Costa, Giacomo Capece, Donato Coppola, Elena Matteini, Pierluigi Del Vecchio, Francesco Taccari, Giuseppe Maccagnano, Carlo Torti, Giulio Maccauro, and Raffaele Vitiello J. Bone Joint Infect., 11, 277–285, https://doi.org/10.5194/jbji-11-277-2026, 2026 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. Mon, 18 May 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-267-2026 Adverse events and tolerability of long-term suppressive antibiotic therapy for periprosthetic joint infection: a prospective cohort study Pia Reinecke, Svetlana Karbysheva, Stavros Goumenos, Anna Conen, Olga Pidgaiska, Carsten Perka, Andrej Trampuz, Thilo Khakzad, and Sebastian Meller J. Bone Joint Infect., 11, 267–275, https://doi.org/10.5194/jbji-11-267-2026, 2026 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. Tue, 12 May 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-257-2026 CarboCell G/C provides sustained high local bone antibiotic levels with minimal systemic exposure, supporting its therapeutic potential in orthopedic infection management Nicole Lind Henriksen, Andrea René Jørgensen, Michal Poborsky, Christoph Crocoll, Niranjan G. Kotla, Catrine Jyde Berthelsen, Mats Bue, Louise Kruse Jensen, Anders Elias Hansen, and Jonas Rosager Henriksen J. Bone Joint Infect., 11, 257–265, https://doi.org/10.5194/jbji-11-257-2026, 2026 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. Fri, 08 May 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-247-2026 Blood gas analyzers enable reliable measurement of synovial pH, lactate, and glucose in native and periprosthetic joint infection: an analytical agreement study Dirk Müller, Igor Lazic, Benjamin Schloßmacher, Vincent Lallinger, Christian Wendler, Rüdiger von Eisenhart-Rothe, and Susanne Weber J. Bone Joint Infect., 11, 247–256, https://doi.org/10.5194/jbji-11-247-2026, 2026 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. Mon, 27 Apr 2026 18:11:29 +0200 https://doi.org/10.5194/jbji-11-237-2026 Rifampin resistance and multidrug resistance or extensive drug resistance (MDR/XDR) predict failure in monomicrobial Staphylococcus epidermidis periprosthetic joint infection (PJI) – a 15-year single-center cohort study Álvaro Auñon, Santiago Gabardo, Carmen Álvaro, Ricardo de la Concha, Javier Sanado, and Jaime Esteban J. Bone Joint Infect., 11, 237–246, https://doi.org/10.5194/jbji-11-237-2026, 2026 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. Tue, 21 Apr 2026 18:11:29 +0200