Diagnosis and Antimicrobial Therapy of Osteoarticular Infection

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 28 February 2025 | Viewed by 5828

Special Issue Editor


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Guest Editor
International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA
Interests: bone infection; joint infection; periprosthetic joint infection; limb lengthening; bone reconstruction

Special Issue Information

Dear Colleagues,

Orthopedic infections represent a pivotal and costly facet in the management of bone and joint disorders. Despite substantial efforts to address this issue through the development of diagnostic and therapeutic methods, lingering questions persist, impeding the attainment of favorable outcomes in these operations. We extend a warm invitation for comprehensive studies focusing on the Diagnosis and Antimicrobial Therapy of Osteoarticular Infection. This Special Issue welcomes original research. By fostering a diverse range of studies, we aim to advance our understanding and enhance the effectiveness of interventions in the complex realm of orthopedic infections.

Dr. Janet D. Conway
Guest Editor

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Keywords

  • bone infection
  • joint infection
  • periprosthetic joint infection
  • orthopaedic infection
  • orthopedic infection

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Published Papers (3 papers)

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Research

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11 pages, 2278 KiB  
Article
Poor Outcomes of Girdlestone Resection Arthroplasty in Injection Drug Users: A Retrospective Study
by Henry T. Shu, Diane Ghanem, Oscar Covarrubias, Zaid Elsabbagh, Alice J. Hughes, Rachel B. Sotsky, Janet D. Conway, Jamie Ferguson, Greg M. Osgood and Babar Shafiq
Antibiotics 2024, 13(8), 782; https://doi.org/10.3390/antibiotics13080782 - 21 Aug 2024
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Abstract
This retrospective cohort study aims to investigate the clinical outcomes of Girdlestone resection arthroplasty (GRA) in injection drug users with septic hip arthritis. Patients who underwent primary GRA for septic hip arthritis secondary to injection drug use at two academic trauma centers from [...] Read more.
This retrospective cohort study aims to investigate the clinical outcomes of Girdlestone resection arthroplasty (GRA) in injection drug users with septic hip arthritis. Patients who underwent primary GRA for septic hip arthritis secondary to injection drug use at two academic trauma centers from 2015 to 2023 were retrospectively reviewed. Patient demographics, surgical details, and follow-up outcomes, including patient-reported outcome measures, were collected and analyzed. The cohort included 15 patients, with a mean age of 44 ± 11 years and a mean follow-up period of 25 ± 20 months. Among the 15 patients, overall mortality was 27%, and only 4 patients underwent total hip arthroplasty (THA) following GRA. Infection resolution rates were significantly higher in patients who received an antibiotic spacer (75% vs. 0%, p = 0.048). GRA in injection drug users is associated with high mortality and low conversion rates to THA. The use of an antibiotic spacer during GRA significantly improves infection resolution rates. Larger studies are required to determine the optimal management strategies for this patient population. Full article
(This article belongs to the Special Issue Diagnosis and Antimicrobial Therapy of Osteoarticular Infection)
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15 pages, 1862 KiB  
Article
Differences in the Synovial Fluid Proteome of Septic and Aseptic Implant Failure
by Andrea Sowislok, André Busch, Farnusch Kaschani, Markus Kaiser and Marcus Jäger
Antibiotics 2024, 13(4), 346; https://doi.org/10.3390/antibiotics13040346 - 9 Apr 2024
Viewed by 1410
Abstract
Implant loosening is a severe complication after total joint replacement. Here, differential diagnosis between septic and aseptic cases is crucial for further surgical treatment, but low-grade periprosthetic joint infections (PJIs) in particular remain a challenge. In this study, we analyzed the synovial fluid [...] Read more.
Implant loosening is a severe complication after total joint replacement. Here, differential diagnosis between septic and aseptic cases is crucial for further surgical treatment, but low-grade periprosthetic joint infections (PJIs) in particular remain a challenge. In this study, we analyzed the synovial fluid proteome of 21 patients undergoing revision surgery for septic (eight cases) or aseptic (thirteen cases) implant failure using LC-MS/MS to identify potential new biomarkers as future diagnostic tools. Staphylococci were found in four cases, Streptococci in two cases, Serratia marcescens and Cutibacterium acnes in one case. Proteomic analysis of the synovial fluid resulted in the identification of 515 different proteins based on at least two peptides. A statistical comparison revealed 37 differentially abundant proteins (p < 0.05), of which 17 proteins (46%) showed a higher abundance in the septic group. The proteins with the highest fold change included the known marker proteins c-reactive protein (7.57-fold) and the calprotectin components protein S100-A8 (4.41-fold) and protein S100-A9 (3.1-fold). However, the protein with the highest fold change was leucine-rich alpha-2-glycoprotein 1 (LRG1) (9.07-fold), a currently discussed new biomarker for inflammatory diseases. Elevated LRG1 levels could facilitate the diagnosis of PJI in the future, but their significance needs to be further investigated. Full article
(This article belongs to the Special Issue Diagnosis and Antimicrobial Therapy of Osteoarticular Infection)
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Review

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14 pages, 300 KiB  
Review
Native Joint Septic Arthritis
by Kevin A. Wu, David N. Kugelman, Jessica L. Seidelman and Thorsten M. Seyler
Antibiotics 2024, 13(7), 596; https://doi.org/10.3390/antibiotics13070596 - 27 Jun 2024
Cited by 2 | Viewed by 3291
Abstract
Native joint septic arthritis (NJSA) is a severe and rapidly progressing joint infection, predominantly bacterial but also potentially fungal or viral, characterized by synovial membrane inflammation and joint damage, necessitating urgent and multidisciplinary management to prevent permanent joint damage and systemic sepsis. Common [...] Read more.
Native joint septic arthritis (NJSA) is a severe and rapidly progressing joint infection, predominantly bacterial but also potentially fungal or viral, characterized by synovial membrane inflammation and joint damage, necessitating urgent and multidisciplinary management to prevent permanent joint damage and systemic sepsis. Common in large joints like knees, hips, shoulders, and elbows, NJSA's incidence is elevated in individuals with conditions like rheumatoid arthritis, diabetes, immunosuppression, joint replacement history, or intravenous drug use. This review provides a comprehensive overview of NJSA, encompassing its diagnosis, treatment, antibiotic therapy duration, and surgical interventions, as well as the comparison between arthroscopic and open debridement approaches. Additionally, it explores the unique challenges of managing NJSA in patients who have undergone graft anterior cruciate ligament (ACL) reconstruction. The epidemiology, risk factors, pathogenesis, microbiology, clinical manifestations, diagnosis, differential diagnosis, antibiotic treatment, surgical intervention, prevention, and prophylaxis of NJSA are discussed, highlighting the need for prompt diagnosis, aggressive treatment, and ongoing research to enhance patient outcomes. Full article
(This article belongs to the Special Issue Diagnosis and Antimicrobial Therapy of Osteoarticular Infection)
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