Journal Of Bone And Joint Infection骨与关节感染杂志
Journal Of Bone And Joint Infection(英文缩写 J BONE JOINT INFECT),ISSN 2206-3552,eISSN 2206-3552,中文译名:骨与关节感染杂志 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
Journal Of Bone And Joint Infection 最新收录文献
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1. External validation of the KLIC score and development of a novel prediction model for debridement, antibiotics, and implant retention failure in prosthetic joint infection: a multicentre cohort study.
PMID:日期:2026-10-02Appropriate estimation of the risk of failure after debridement, antibiotics, and implant retention (DAIR) may provide useful prognostic information in patients with prosthetic joint infection (PJI). We aimed to externally validate the Kidney, Liver, Index surgery, Cemented prosthesis, C-reactive protein (KLIC) score and to develop and internally validate a new prediction model based on variables available before DAIR. We conducted a retrospective multicentre cohort study using medical record data from adults with PJI treated with DAIR across eight Spanish centres between 2006 and 2023, with a minimum 12-month follow-up. Predictors were analysed using a generalized linear mixed-effects model, with assessment of discrimination, calibration, and bootstrap internal validation. Among 224 patients, 121 (54 %) experienced DAIR failure. The final model retained revision prosthesis, Charlson Comorbidity Index 3, C-reactive protein 150 mg L, longer time from index arthroplasty to DAIR, and Gram-negative bacilli or polymicrobial infection. The model showed good discrimination (Areas under the receiver operating characteristic curve (AUC-ROC) 0.85; 95 % confidence interval (CI) 0.79-0.90) and satisfactory calibration; the optimism-corrected AUC-ROC was 0.83. The derived clinical score showed an AUC-ROC of 0.81 (95 % CI 0.75-0.87) and identified groups with observed failure rates of 25.5 %, 45.6 %, and 87.9 %. The KLIC score did not demonstrate discriminative ability beyond chance (AUC-ROC 0.53; 95 % CI 0.44-0.64). Excluding microbiological aetiology reduced discrimination to 0.81 for the multivariable model and 0.77 for the corresponding reduced score. The new model showed good discrimination and calibration in this cohort, but external validation in independent PJI-DAIR populations is required before clinical implementation can be recommended.
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2. Long-term outcomes of vascularized fibular grafting for infected non-union of the lower limb: a competing-risk analysis.
PMID:日期:2026-09-15: Infected non-union of the lower limb is among the most challenging conditions in orthopedic surgery. Vascularized fibular grafting (VFG) is a limb-salvage option for large infected bone defects, but outcomes accounting for competing events remain poorly documented. : We conducted a retrospective single-center study of adults treated consecutively with VFG for infected femoral or tibial non-union between 2014 and 2023. Infected non-union combined institutional non-union criteria with fracture-related infection as per international consensus definitions. Treatment success was defined as consolidation with infection remission. Amputation and death were competing events; cumulative incidence of consolidation was estimated using competing-risk methods. : A total of 22 patients were included (median age of 45 years). Consolidation was achieved in 17 patients (77 %), infection remission was achieved in 16 (73 %), and treatment success was achieved in 16 (73 %): 9 (41 %) after VFG alone and 7 (32 %) after secondary bone grafting. Six patients (27 %) had unfavorable outcomes: four amputations, one persistent non-union, and one death. The median time to consolidation was 14 months after VFG alone and 38 months after secondary grafting. Cumulative incidence of consolidation reached approximately 18 % at 12 months, 41 % at 24 months, 59 % at 36 months, and 76 % by end of follow-up. All seven patients undergoing secondary grafting for delayed consolidation ultimately achieved union; no formal comparative analysis was performed given the small, time-dependent sample. : VFG is a valuable limb-salvage strategy for selected patients with infected non-union. Consolidation may occur late, underscoring the need for prolonged follow-up and competing-risk methodology. Findings should be interpreted given the retrospective design, small sample, and heterogeneous follow-up.
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3. Investigating long-term quality of life and depressive symptoms following fracture-related infection: a systematic review with meta-analysis of heterogeneous evidence.
PMID:日期:2026-09-14: Fracture-related infection (FRI) is associated with prolonged treatment courses and functional impairment. However, the long-term effects of FRI on quality of life (QoL) and psychological outcomes remain unclear. : A PRISMA-compliant systematic review of PubMed, Web of Science, and Google Scholar for studies published from 2010 to August 2025 was performed. Methodological quality and bias were assessed with Methodological Index for Non-Randomised Studies (MINORS) and ROBINS-I. Where appropriate, data were synthesized using random-effects models and interpreted cautiously due to substantial heterogeneity. : Fifteen studies met the inclusion criteria. The evidence base is dominated by retrospective cohorts: mean MINORS attainment 66.4 % and mean loss to follow-up 19.5 %. Meta-analysis of three studies ( ) showed non-significant mean changes at 12 months or more in SF-36 and SF-12 physical component score (PCS) of 5.81 (SD 6.54, ) and 3.86, (9.12, ) in the mental component (MCS). Pooled long-term estimates from seven studies ( ) were 38.9 (2.18) for PCS and 51.2 (4.11) for MCS. Compared with US population norms, PCS was reduced, whereas differences in mental QoL were not significant. Three studies ( ) assessing psychological symptoms using the ISR reported elevated depressive symptom and total ISR scores exceeding established caseness thresholds. : Current evidence suggests persistent physical and psychological burden after FRI treatment. However, heterogeneity, limited study quality, evolving FRI definitions, and a lack of appropriate comparison groups prevent definitive conclusions. Prospective studies using standardized outcome measures are required.
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4. Clinical case of polymicrobial and multidrug-resistant posttraumatic chronic hip infection treatment.
PMID:日期:2026-09-10A 40-year-old man, after a left acetabular fracture, had eight surgeries, suffered from chronic multidrug-resistant infection with fistula, and underwent multi-stage hip revision surgery with spacer exchange and reconstruction, combined with systemic and intra-articular antibiotic therapy. He remained infection-free at 3.5-year follow-up.
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5. Sonication versus peri-implant tissue culture in fracture-related infection: diagnostic performance and therapeutic consequences in a single-center cohort.
PMID:日期:2026-08-26: Fracture-related infections (FRIs) represent a severe complication and pose diagnostic challenges due to biofilm-associated microorganisms. While peri-implant tissue culture (PTC) remains the standard, its sensitivity is limited. Sonication of explanted osteosynthesis material has been proposed as a complementary diagnostic tool; however, its contribution remains controversial. The aim of this study was to compare sonication and peri-implant tissue culture and their impact on antimicrobial management. : In this retrospective single-center study, all patients undergoing implant removal for FRI between 2016 and 2023 were screened. Cases with peri-implant tissue cultures and sonication fluid cultures (SFCs) were included. The diagnostic yield and pathogen spectrum of PTC and SFC were compared, including analyses in patients receiving antibiotic therapy. The impact of microbiological findings on antibiotic management was evaluated. : Of 287 screened cases, 157 patients met the inclusion criteria. Pathogen detection was achieved in 60.5 % using PTC and 57.3 % using SFC. Incorporating both methods increased the diagnostic yield to 70.1 %. Sonication identified additional pathogens in 17.8 % of cases and PTC in 22.9 %. Under antibiotic therapy, PTC demonstrated a slightly higher diagnostic yield than SFC. Antibiotic therapy was modified after revision surgery in 47.8 % of cases, while sonication alone influenced treatment decisions in 4.5 % of patients. : Neither PTC nor SFC alone achieved the diagnostic performance of their combined use. Combined testing improved diagnostic yield, supported targeted antimicrobial management, and reinforced the value of a multimodal microbiological approach to FRI.
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6. Periprosthetic fractures around chronically infected total hip arthroplasties: a case series and pragmatic two-stage treatment framework.
PMID:日期:2026-08-25Three periprosthetic femoral fractures around chronically infected total hip arthroplasties (THAs) were treated according to a pragmatic two-stage treatment framework. Infection control and fracture healing were achieved. This may serve as a reference for surgeons confronted with these complex and technically demanding situations.
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7. Feasibility of a rat femoral-defect model for immediate perioperative and delayed post-implantation implant-associated bone infections.
PMID:日期:2026-08-25: Implant-associated bone infections (IAIs) represent a major clinical challenge, causing implant failure, prolonged morbidity, and costly revision surgeries. Infection risk is highest in the immediate perioperative period, but delayed post-implantation contamination, occurring weeks after surgery in a partially healed host, represents an equally important and underappreciated clinical scenario. Bacteria rapidly colonize implant surfaces and form biofilms that resist both antibiotics and host immune responses, making prevention critical. Well-characterized small-animal models that capture both early and delayed post-implantation infections are therefore essential to develop and test antibacterial implants and coatings. : We developed a rat femoral-segmental-defect model stabilized with a polyether-ether-ketone plate and a 3D-printed porous titanium implant. Three studies were performed using a total of 28 animals (3 excluded due to early humane endpoints; in final analysis): (i) early inoculation during surgery with planktonic (ATCC 49230) at 10 or 10 CFU (colony-forming units) per rat, (ii) delayed inoculation 28 d after surgery with planktonic at 10 or 10 CFU per rat, and (iii) delayed inoculation with 10 CFU per rat delivered as planktonic or ruptured-biofilm inoculum. Controls received phosphate-buffered saline at implantation. The primary endpoint was infection at day 14, quantified by CFU enumeration from homogenized bone and from a sonicated implant, plate, and screws. Micro-computed tomography (micro-CT) was used to visualize fixation and hardware position. : Early inoculation with 10 or 10 CFU per rat produced consistent infections across bone, implants, and screws. The same doses given 28 d later yielded low and inconsistent colonization. Escalation to 10 CFU per rat in the delayed setting produced consistent infections; the ruptured-biofilm inoculum generated higher implant-associated bacterial burdens than planktonic suspensions, while bone burdens were consistently high in both arms. : This femoral-implant rat model demonstrates feasibility for studying both immediate perioperative and delayed post-implantation infections, providing a platform for preclinical evaluation of anti-infection strategies. Timing, inoculum magnitude, and bacterial state critically determine infection establishment.
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8. Socioeconomic burden of septic re-revision surgeries for periprosthetic joint infections in Europe - a comprehensive analysis of re-revision costs.
PMID:日期:2026-08-24Periprosthetic joint infection (PJI) is a major cause of failure after total hip arthroplasty (THA) and total knee arthroplasty (TKA). While primary PJI treatment costs are increasingly recognized, the economic burden of septic re-revision surgery remains poorly defined. This study estimated septic re-revisions and the reimbursement burden across Europe. A payor-perspective health-economic model was applied to 30 European countries, combining 2023 Eurostat arthroplasty data with published infection rates to estimate PJIs and septic re-revisions (including after aseptic revisions), categorized as DAIR (debridement, antibiotics, and implant retention), one-stage, or two-stage procedures. Reimbursement used 13-country survey data plus GDP-based extrapolation; sensitivity analyses varied key parameters by 20 %. In 2023, 2.29 million primary arthroplasties were performed in Europe, resulting in an estimated 22 794 PJIs and 8629 septic re-revisions. Total reimbursement costs were estimated at EUR 123.6 million (EUR 74.1 million THA; EUR 49.5 million TKA), split into EUR 111.6 million after primary PJI treatment and EUR 12.0 million after initially aseptic revision. Two-stage exchanges accounted for 82.8 % of expenditures and were the main cost driver; Germany had the highest national costs. A Monte Carlo probabilistic sensitivity analysis yielded a 95 % credibility interval of EUR 102.0-156.2 million. Septic re-revision surgery after arthroplasty represents a substantial economic burden in Europe, largely driven by two-stage exchange procedures. Reducing infection and treatment failure rates may provide major clinical and financial benefits: a 25 % reduction in PJI incidence could save EUR 27.9 million annually (22.6 %), and shifting half of two-stage cases to one-stage a further EUR 22.6 million (18.3 %).
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9. Reinfection and complication rates in two-stage revision for chronic hip periprosthetic joint infections using the direct anterior approach.
PMID:日期:2026-08-19The direct anterior approach (DAA) used in primary total hip arthroplasty (THA) is gaining popularity and has infection rates comparable to other surgical approaches. While two-stage revision remains the gold standard for chronic periprosthetic joint infection (PJI), little data exist on the DAA. This study evaluated reinfection, and complication rates of two-stage septic revisions performed using the DAA. This retrospective single-center study included data from 8476 patients who underwent primary THA using the DAA between 2013 and 2024. All patients who underwent a two-stage procedure for chronic PJI were included. Clinical outcomes, complication rates, and microbiological spectrum were assessed. All patients received an antibiotic-loaded cement spacer at first stage, followed by antimicrobial therapy. We identified 36 8476 (0.4 %) patients (female: 41.7 %, male: 58.3 %) who underwent septic two-stage revision after primary DAA THA. Infection-free survival was 83.4 % at a median 6.2-year follow-up. Successful second-stage reimplantation occurred in 28 36 patients (77.8 %), while 2 36 (5.6 %) remained infection free after a 1.5-stage procedure due to being clinically unfit for reimplantation. Four patients (11.1 %) underwent a second stage but developed reinfection, requiring septic revision. Two patients (5.6 %) had failed first stage and underwent a Girdlestone procedure. The reinfection rate was 11.1 %, all culture positive at the second stage. Spacer-related complications occurred in 2 36 (5.6 %), including one dislocation (2.8 %) and one spacer fracture (2.8 %). Revision for dislocation after the second stage was required in 3 36 (8.3 %). Patients with successful reimplantation were younger ( 0.001). Most common microorganisms were spp. (28.8 %) and coagulase-negative (26.9 %). Two-stage septic revision using the DAA shows reinfection rates comparable to other approaches, with low rates of spacer dislocation and postoperative dislocation after reimplantation.
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10. Postoperative inflammatory markers and surgical wound infection after elective short-segment lumbar fusion: the importance of surgical context.
PMID:日期:2026-08-18: Postoperative white blood cell (WBC) count and neutrophil-to-lymphocyte ratio (NLR) are routinely available after lumbar fusion, but early elevations may reflect surgical stress. We evaluated associations of postoperative day (POD) 1 and POD3 WBC/NLR with 90 d surgical wound infection (SWI) after elective short-segment lumbar fusion. : This retrospective cohort included adults undergoing elective one- to three-level lumbar fusion from 2022 to 2024 at one academic center. SWI was a pragmatic electronic-health-record-based endpoint encompassing clinically documented wound-related events, not a uniformly culture-confirmed deep, implant-associated, or surveillance-defined infection. Complete-case univariable and parsimoniously adjusted logistic regressions examined WBC/NLR associations with SWI. : Among 380 outcome-eligible patients, 18 (4.7 %) developed SWI. POD1 analyses included 368 patients (18 events), POD3 analyses 336 (17 events), and paired analyses 327 (17 events). After adjustment for body mass index and operative duration, POD1 associations were attenuated; POD3 WBC (odds ratio 1.17, 95 % confidence interval 1.00-1.37; ) and NLR (odds ratio 1.12, 95 % confidence interval 1.01-1.23; ) remained associated with SWI. However, these associations weakened after adjustment for corresponding POD1 values. Absolute and percentage POD1-to-POD3 changes were not significantly associated with SWI. : POD1 WBC/NLR elevations were associated with patient and operative context. POD3 values showed exploratory associations with SWI after limited adjustment but did not establish diagnostic thresholds, clinical utility, or a validated prediction model.