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Diagnostics
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Diagnosis and Management of Bone Infection
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Diagnosis and Management of Bone Infection

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 6464

Special Issue Editors

Mr. Nima Heidari

E-Mail Website
Guest Editor
Consultant Orthopaedic and Trauma Surgeon, Orthopaedic Surgeon, Lead for Limb Reconstruction, The Royal London Limb Reconstruction Service, Royal London Hospital, Barts Health NHS Trust, UK
Interests: bone infection; limb deformity; limb reconstruction; complex trauma; joint preservation
Prof. Dr. Andrej Trampuz

E-Mail Website
Guest Editor
Consultant for Infectious Diseases, Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
Interests: implant associated infection; biofilm

Special Issue Information

Dear Colleagues,

Bone infection represents a diagnostic and therapeutic challenge. Accurate diagnosis and correct surgical treatment in combination with targeted antimicrobials are prerequisites to achieving the best outcome. The aim of treatment is the eradication of the infection and the restoration of skeletal anatomy in order to maintain and regain bone biological function. The management of bone infection needs surgical intervention to remove dead and infected tissue and reestablish skeletal (bone and soft tissue) integrity. One of the challenges is the targeting of microorganisms growing within bone and soft tissues and on medical devices in the form of biofilm, which are difficult to detect and eradicate. In this Special Issue, concepts related to the prevention and treatment of infection associated with open fractures and internal fracture fixation will be reviewed. The key to success is a multi-disciplinary team approach integrating clinical expertise, diagnostic algorithms, appropriate surgery, and local and systemic antimicrobials. It is also necessary to consider some specific aspects in special circumstances such as the presence of diabetic foot infections, peri-prosthetic joint infections, and infection in children that require a nuanced approach. Studies in these areas are also welcomed.

Dr. Nima Heidari
Dr. Andrej Trampuz
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Basics of biofilm
  • Action of biofilm-active antibiotics
  • Fracture-related infections – Pathogenesis, classification, Diagnostic criteria
  • Diagnostic approach – preoperative & intraoperative tests
  • Surgical principles – Algorithmic approach
  • Management of bone defects
  • Management of soft tissue defects
  • Antimicrobial principles – local and systemic antibiotics
  • Novel and innovative approaches: bacteriophages, implant coatings, enzymes, electricity, sonication

Published Papers (2 papers)

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Research

10 pages, 506 KiB  
Article
Predictive Value of Neutrophil–Lymphocyte Ratio as a Marker in Antiresorptive Agent-Related Osteonecrosis of the Jaw: A Retrospective Analysis
by Kazuto Kurohara, Kasumi Shimizu, Taku Murata, Gaku Koizumi, Akira Takigawa, Kokoro Nagata, Kenya Okumura and Naoya Arai
Diagnostics 2022, 12(8), 1836; https://doi.org/10.3390/diagnostics12081836 - 29 Jul 2022
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Abstract
Antiresorptive agent-related osteonecrosis of the jaw (ARONJ), a multifactorial disease, can drastically affect a patient’s quality of life. Moreover, disease progression to severe acute inflammation can hinder treatment. Therefore, we aimed to investigate the diagnostic value of the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte [...] Read more.
Antiresorptive agent-related osteonecrosis of the jaw (ARONJ), a multifactorial disease, can drastically affect a patient’s quality of life. Moreover, disease progression to severe acute inflammation can hinder treatment. Therefore, we aimed to investigate the diagnostic value of the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in predicting the risk of acute inflammation in patients with ARONJ. In total, 147 patients with ARONJ were enrolled between 1 January 2011 and 31 December 2019. They were divided into two groups according to their baseline NLR (high NLR vs. low NLR) or PLR (high PLR vs. low PLR) to analyze the relationship between NLR and PLR and the outcomes of acute inflammatory events. An optimal NLR cut-off value of 2.83 was identified for hospitalization for an inflammatory event. Logistic regression analysis showed that NLR > 2.83 was associated with an increased risk of hospitalization for an inflammatory event. A PLR cut-off value of 165.2 was identified for hospitalization for an inflammatory event. However, logistic regression analysis showed that PLR > 165.2 was not significantly associated with hospitalization for an inflammatory event. Our study findings suggest that the NLR has diagnostic value in predicting the risk of hospitalization for inflammatory events among patients with ARONJ. Full article
(This article belongs to the Special Issue Diagnosis and Management of Bone Infection)
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11 pages, 1167 KiB  
Article
Outcome Analysis of the Use of Cerament® in Patients with Chronic Osteomyelitis and Corticomedullary Defects
by Marcel Niemann, Frank Graef, Sufian S. Ahmad, Karl F. Braun, Ulrich Stöckle, Andrej Trampuz and Sebastian Meller
Diagnostics 2022, 12(5), 1207; https://doi.org/10.3390/diagnostics12051207 - 11 May 2022
Cited by 10 | Viewed by 4616
Abstract
Background: Chronic osteomyelitis (OM) is a progressive but mostly low-grade infection of the bones. The management of this disease is highly challenging for physicians. Despite systematic treatment approaches, recurrence rates are high. Further, functional and patient-reported outcome data are lacking, especially after osseous [...] Read more.
Background: Chronic osteomyelitis (OM) is a progressive but mostly low-grade infection of the bones. The management of this disease is highly challenging for physicians. Despite systematic treatment approaches, recurrence rates are high. Further, functional and patient-reported outcome data are lacking, especially after osseous defects are filled with bioresorbable antibiotic carriers. Objective: To assess functional and patient-reported outcome measures (PROM) following the administration of Cerament® G or V due to corticomedullary defects in chronic OM. Methods: We conducted a retrospective study from 2015 to 2020, including all patients who received Cerament® for the aforementioned reason. Patients were diagnosed and treated in accordance with globally valid recommendations, and corticomedullary defects were filled with Cerament® G or V, depending on the expected germ spectrum. Patients were systematically followed up, and outcome measures were collected during outpatient clinic visits. Results: Twenty patients with Cierny and Mader type III OM were included in this study and followed up for 20.2 ± 17.2 months (95%CI 12.1–28.3). Ten of these patients needed at least one revision (2.0 ± 1.3 revisions per patient (95%CI 1.1–2.9) during the study period due to OM persistence or local wound complications. There were no statistically significant differences in functional scores or PROMs between groups. Conclusion: The use of Cerament® G and V in chronic OM patients with corticomedullary defects appears to have good functional outcomes and satisfactory PROMs. However, the observed rate of local wound complications and the OM persistence rate may be higher when compared to previously published data. Full article
(This article belongs to the Special Issue Diagnosis and Management of Bone Infection)
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