https://jbji.copernicus.org/articles/ Recent articles of the journal Journal of Bone and Joint Infection en https://doi.org/10.5194/jbji-11-343-2026 https://doi.org/10.5194/jbji-11-343-2026 <b>Intrawound vancomycin powder in orthopaedic surgery after the VPIP trial: a critical reappraisal of efficacy, dosing, application plane, and antimicrobial stewardship</b><br> Felix Werneburg, Alexander Zeh, Natalia Gutteck, and Karl-Stefan Delank<br> J. Bone Joint Infect., 11, 343–354, https://doi.org/10.5194/jbji-11-343-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-337-2026 https://doi.org/10.5194/jbji-11-337-2026 <b>“ID-ing” the value: how are orthopaedic infectious disease physicians compensated for their time? A national survey</b><br> Jessica C. O'Neil, Bethany Lehman, Thorsten Seyler, Nicolas Piuzzi, Sean Ryan, Jessica Seidelman, Julie Reznicek, and Poorani Sekar<br> J. Bone Joint Infect., 11, 337–342, https://doi.org/10.5194/jbji-11-337-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-331-2026 https://doi.org/10.5194/jbji-11-331-2026 <b>Primary hip or knee arthroplasty in the setting of chronic suppressive antibiotics for prior periprosthetic joint infection: a scoping review</b><br> Vincent K. Melemai, Ryan J. Blake, Christian Barill, Adam E. Klein, Matthew J. Dietz, and Allison M. Lastinger<br> J. Bone Joint Infect., 11, 331–336, https://doi.org/10.5194/jbji-11-331-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-323-2026 https://doi.org/10.5194/jbji-11-323-2026 <b>High intra- and inter-observer reliability of the PJI-TNM classification in acute and chronic periprosthetic hip joint infection</b><br> Dominic Simon, Jonas Tumler, Lennart M. Schroeder, Florian Pachmann, Eduardo Suero, Boris M. Holzapfel, Gautier Beckers, and Kathrin Pfahl<br> J. Bone Joint Infect., 11, 323–330, https://doi.org/10.5194/jbji-11-323-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-315-2026 https://doi.org/10.5194/jbji-11-315-2026 <b>Tapping our resources: do preoperative aspirations add diagnostic value in hip and knee periprosthetic joint infection?</b><br> Anne Spichler-Moffarah, Lauren Daddi, Ilda Molloy, Tyler Luu, Duc Nguyen, and Marjorie Golden<br> J. Bone Joint Infect., 11, 315–321, https://doi.org/10.5194/jbji-11-315-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-305-2026 https://doi.org/10.5194/jbji-11-305-2026 <b>Sinus tract and purulence as clinical criteria for periprosthetic joint infection: diagnostic accuracy, microorganisms, and clinical outcomes</b><br> Markus Luger, Martin McNally, Lukas Rabitsch, Reinhard Windhager, Richard Lass, and Irene Katharina Sigmund<br> J. Bone Joint Infect., 11, 305–313, https://doi.org/10.5194/jbji-11-305-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-299-2026 https://doi.org/10.5194/jbji-11-299-2026 <b>Nasal decolonization in total joint arthroplasty: current state of evidence</b><br> Andrea Zampoli, Ghazal Pourbozorg, Goksel Dikmen, Ibrahim Tuncay, and Javad Parvizi<br> J. Bone Joint Infect., 11, 299–304, https://doi.org/10.5194/jbji-11-299-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-287-2026 https://doi.org/10.5194/jbji-11-287-2026 <b>Can we identify which patients are likely to have septic arthritis with borderline synovial fluid cell counts?</b><br> Boshen Liu, Michael Raffetto, Eric J. Abbenhaus, Gavin S. Hautala, William R. Taylor, Lucy Bowers, and Paul Edward Matuszewski<br> J. Bone Joint Infect., 11, 287–297, https://doi.org/10.5194/jbji-11-287-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-277-2026 https://doi.org/10.5194/jbji-11-277-2026 <b>The use of debridement, antibiotic pearls, and implant retention (DAPRI) in the management of acute periprosthetic joint infections: a systematic review</b><br> Doriana Di Costa, Giacomo Capece, Donato Coppola, Elena Matteini, Pierluigi Del Vecchio, Francesco Taccari, Giuseppe Maccagnano, Carlo Torti, Giulio Maccauro, and Raffaele Vitiello<br> J. Bone Joint Infect., 11, 277–285, https://doi.org/10.5194/jbji-11-277-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-267-2026 https://doi.org/10.5194/jbji-11-267-2026 <b>Adverse events and tolerability of long-term suppressive antibiotic therapy for periprosthetic joint infection: a prospective cohort study</b><br> Pia Reinecke, Svetlana Karbysheva, Stavros Goumenos, Anna Conen, Olga Pidgaiska, Carsten Perka, Andrej Trampuz, Thilo Khakzad, and Sebastian Meller<br> J. Bone Joint Infect., 11, 267–275, https://doi.org/10.5194/jbji-11-267-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-257-2026 https://doi.org/10.5194/jbji-11-257-2026 <b>CarboCell G/C provides sustained high local bone antibiotic levels with minimal systemic exposure, supporting its therapeutic potential in orthopedic infection management</b><br> 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<br> J. Bone Joint Infect., 11, 257–265, https://doi.org/10.5194/jbji-11-257-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-247-2026 https://doi.org/10.5194/jbji-11-247-2026 <b>Blood gas analyzers enable reliable measurement of synovial pH, lactate, and glucose in native and periprosthetic joint infection: an analytical agreement study</b><br> Dirk Müller, Igor Lazic, Benjamin Schloßmacher, Vincent Lallinger, Christian Wendler, Rüdiger von Eisenhart-Rothe, and Susanne Weber<br> J. Bone Joint Infect., 11, 247–256, https://doi.org/10.5194/jbji-11-247-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-237-2026 https://doi.org/10.5194/jbji-11-237-2026 <b>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</b><br> Álvaro Auñon, Santiago Gabardo, Carmen Álvaro, Ricardo de la Concha, Javier Sanado, and Jaime Esteban<br> J. Bone Joint Infect., 11, 237–246, https://doi.org/10.5194/jbji-11-237-2026, 2026<br> 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 15:50:18 +0200 https://doi.org/10.5194/jbji-11-229-2026 https://doi.org/10.5194/jbji-11-229-2026 <b>Empirical antibiotic therapy in acute orthopaedic infections: differences in antimicrobial susceptibility across anatomical sites</b><br> Yoni Lodewijk-van den Brink, Jon H. M. Goosen, Denise S. C. Telgt, Marrigje Nabuurs-Franssen, and Karin C. M. Veerman<br> J. Bone Joint Infect., 11, 229–235, https://doi.org/10.5194/jbji-11-229-2026, 2026<br> 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. Wed, 15 Apr 2026 15:50:18 +0200 https://doi.org/10.5194/jbji-11-219-2026 https://doi.org/10.5194/jbji-11-219-2026 <b>Twenty common errors in the prevention, diagnosis, and treatment of fracture-related infection (FRI)</b><br> Goran Georgievski, Nike Walter, Ronald Man Yeung Wong, Irene Katharina Sigmund, Ashok Kanuri, Christian Heiss, and Markus Rupp<br> J. Bone Joint Infect., 11, 219–228, https://doi.org/10.5194/jbji-11-219-2026, 2026<br> 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. Mon, 13 Apr 2026 15:50:18 +0200 https://doi.org/10.5194/jbji-11-207-2026 https://doi.org/10.5194/jbji-11-207-2026 <b>Is there a role for lavage aspiration after a dry tap in the work-up for potential periprosthetic joint infection? A systematic review</b><br> Sander Bruyninckx, Stijn Ghijselings, Melissa Depypere, Alex Soriano, Willem-Jan Metsemakers, and Georges Vles<br> J. Bone Joint Infect., 11, 207–217, https://doi.org/10.5194/jbji-11-207-2026, 2026<br> 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. Thu, 09 Apr 2026 15:50:18 +0200 https://doi.org/10.5194/jbji-11-191-2026 https://doi.org/10.5194/jbji-11-191-2026 <b>Bone transport in the management of fracture-related infection: current concepts and innovations</b><br> Willem-Jan Metsemakers, Austin T. Fragomen, Mario Morgenstern, Steffen B. Rosslenbroich, Stephen M. Quinnan, Pablo S. Corona, Mitchell Bernstein, and Kevin Tetsworth<br> J. Bone Joint Infect., 11, 191–206, https://doi.org/10.5194/jbji-11-191-2026, 2026<br> 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. Wed, 01 Apr 2026 15:50:18 +0200 https://doi.org/10.5194/jbji-11-185-2026 https://doi.org/10.5194/jbji-11-185-2026 <b>A hidden threat: a case of relapsed disseminated Mycobacterium abscessus infection and its therapeutic challenges</b><br> Katherine Grace Egan, Lisa Duffy, Catherine Fleming, Padraig McGettrick, Eavan G. Muldoon, Christine Kelly, James Woo, Emer Kilbride, Joseph Butler, Richard Storey, Christine Quinlan, Edward McDermott, Jonathan Hunter, and Carlos Mejia-Chew<br> J. Bone Joint Infect., 11, 185–189, https://doi.org/10.5194/jbji-11-185-2026, 2026<br> 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. Mon, 30 Mar 2026 15:50:18 +0200 https://doi.org/10.5194/jbji-11-175-2026 https://doi.org/10.5194/jbji-11-175-2026 <b>Diagnostic parameters in native joint septic arthritis and development of a new evaluation score</b><br> Lorenz Huber, Hasan S. Aguicenoglu, Susanne Baertl, Julia Elisabeth Lenz, Kristina Gerhardinger, Frank Hanses, Florian Zeman, Nike Walter, Volker Alt, and Markus Rupp<br> J. Bone Joint Infect., 11, 175–183, https://doi.org/10.5194/jbji-11-175-2026, 2026<br> 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. Mon, 23 Mar 2026 15:50:18 +0100 https://doi.org/10.5194/jbji-11-161-2026 https://doi.org/10.5194/jbji-11-161-2026 <b>Combined analysis of host immune response, biofilm genes, and 16S rRNA detection in fracture-related infection: an observational cohort study</b><br> Melissa Depypere, Jonathan Sliepen, Jolien Onsea, Yves Debaveye, T. Fintan Moriarty, Elena Della Bella, Emmanuel André, Johan Van Weyenbergh, and Willem-Jan Metsemakers<br> J. Bone Joint Infect., 11, 161–173, https://doi.org/10.5194/jbji-11-161-2026, 2026<br> 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.  Thu, 12 Mar 2026 15:50:18 +0100