Contributors xiii

Foreword xvii

Acknowledgments xix

Chapter 1 Introduction 1
Werner Zimmerli

Chapter 2 Microbiology of Bone and Joint Infections 5
Seong Yeol Ryu and Robin Patel

Microorganisms in Osteomyelitis 5

Microorganisms in Implant-Associated Bone and Joint Infection 7

Microorganisms in Native Joint Arthritis 10

Diagnostic Approach in Osteomyelitis 11

Diagnostic Approach in Foreign Body–Associated Infection 12

Diagnostic Approach in Native Joint Infection 15

Novel Diagnostic Procedures 17

Acknowledgment 17

References 17

Chapter 3 Pharmacokinetics and Pharmacodynamics of Antibiotics in Bone 21
Cornelia B. Landersdorfer, Jürgen B. Bulitta, and Fritz Sörgel

Pharmacokinetics 21

Bone Sample Preparation and Analysis 22

Pharmacokinetic Sampling and Data Analysis 23

Penetration of Antibiotics into Bone 24

Pharmacodynamics and Monte Carlo Simulations 31

Conclusions 34

Key Points 34

References 35

Chapter 4 Preclinical Models of Infection in Bone and Joint Surgery 39
Lorenzo Calabro, R. Geoff Richards, and T. Fintan Moriarty

Introduction 39

Influence of Species in Preclinical Models of Bone and Joint Infection 40

Overview of Animal Models 42

Direct Inoculation with Minimal Trauma 42

Animal Osteomyelitis Models Incorporating Trauma 46

Hematogenous Models 47

Future Directions 48

Conclusion 49

Key Points 49

References 49

Chapter 5 Native Joint Arthritis in Children 55
Pablo Yagupsky

Introduction 55

Epidemiology 55

Microbiology 56

Pathogenesis 61

Clinical Presentation 62

Laboratory Investigation 63

Imaging Studies 66

Differential Diagnosis 66

Treatment 67

Prognosis 71

Key Points 72

References 72

Chapter 6 Native Joint Arthritis 77
Ilker Uçkay, Mohamed Al-Mayahi, Domizio Suvà, Daniel Lew, and Pierre Vaudaux

Introduction 77

Pathogenesis, Epidemiology, and Microbiology 77

Diagnosis 79

Treatment 81

Outcome of Native Joint Septic Arthritis 87

Key Points 88

Acknowledgments 88

References 88

Chapter 7 Septic Arthritis of Axial Joints 93
Werner Zimmerli

Septic Arthritis of the Sternoclavicular Joint 93

Key Points 98

Septic Arthritis of the Symphysis Pubis 98

Key Points 103

Septic Arthritis of the Sacroiliac Joint 103

Key Points 107

References 107

Chapter 8 Periprosthetic Joint Infection: General Aspects 113
Werner Zimmerli

Introduction 113

Definition 114

Classification 115

Pathogenesis 115

Diagnostic Algorithm 118

Laboratory Investigation 119

Therapeutic Management 121

Prophylaxis 122

Errors in the Management of PJI 123

Key Points 124

References 124

Chapter 9 Periprosthetic Joint Infection after Total Hip and Knee Arthroplasty 131
Werner Zimmerli and Martin Clauss

Introduction 131

Risk Factors 131

Microbiology 132

Clinical Features 133

Laboratory Investigation 133

Imaging Procedures 134

Management 135

Instructive Cases 142

References 146

Chapter 10 Periprosthetic Joint Infection after Shoulder Arthroplasty 151
Parham Sendi, Beat K. Moor, and Matthias A. Zumstein

Introduction 151

Risk Factors 151

Microbiology 153

Pathogenesis 154

Clinical Features 154

Laboratory Investigation 155

Imaging Procedures 157

Management 158

Instructive Cases 162

References 163

Chapter 11 Periprosthetic Joint Infection after Elbow Arthroplasty 167
Yvonne Achermann and Michael C. Glanzmann

Introduction 167

Microbiology 168

Clinical Features 168

Diagnostic Procedures 169

Instructive Cases 176

References 179

Chapter 12 Periprosthetic Joint Infection after Ankle Arthroplasty 183
Parham Sendi, Bernhard Kessler, and Markus Knupp

Introduction 183

History of Total Ankle Arthroplasty 184

Risk Factors 185

Microbiology 186

Management 189

Instructive Cases 192

References 194

Chapter 13 Osteomyelitis: Classification 197
Werner Zimmerli

Classification According to Pathogenesis 197

Classification According to the Duration of Infection 199

Classification According to the Localization 200

Classification According to the Presence of an Implant 200

Classification According to Anatomy and Comorbidity 200

References 201

Chapter 14 Osteomyelitis in Children 205
Priya Sukhtankar, Saul N. Faust, and Nicholas M.P. Clarke

Introduction 205

Epidemiology 205

Pathophysiology 206

Clinical Presentation, Diagnosis, and Microbiology 207

Treatment 214

Complications 217

Key Points 217

References 217

Chapter 15 Acute Osteomyelitis in Adults 221
Werner Zimmerli

Introduction 221

Pathogenesis 221

Epidemiology 223

Microbiology 224

Risk Factors 225

Clinical Features 227

Laboratory Investigation 229

Imaging Procedures 231

Clinical and Imaging Differential Diagnosis 232

Treatment 233

Key Points 236

References 236

Chapter 16 Subacute Osteomyelitis: Tuberculous and Brucellar Vertebral Osteomyelitis 241
Juan D. Colmenero and Pilar Morata

Introduction 241

Epidemiology 241

Clinical Features 242

Laboratory Investigation 244

Imaging Procedures 247

Antimicrobial and Surgical Therapy 250

Key Points 252

References 252

Chapter 17 Chronic Osteomyelitis in Adults 257
Silvin Lito, Antoine Lomessy, Pierre Vaudaux, and Ilker Uçkay

Introduction 257

Epidemiology and Pathogenesis 259

Diagnosis 260

Treatment 262

Future Perspectives 268

Key Points 268

Acknowledgments 269

References 269

Chapter 18 Diabetic Foot Osteomyelitis 273
Eric Senneville and Sophie Nguyen

Introduction 273

Classification 273

Microbiology 276

Risk Factors 278

Clinical Features 279

Inflammatory Parameters 279

Imaging Procedures 280

Management 281

Prevention 284

References 284

Chapter 19 Osteomyelitis of the Jaws 289
Werner Zimmerli

Introduction 289

Classification 289

Microbiology 291

Risk Factors 292

Clinical Features 292

Laboratory Investigation 294

Imaging Procedures 296

Management 297

Key Points 299

References 299

Chapter 20 Implant-Associated Osteomyelitis of Long Bones 303
Martin McNally and Parham Sendi

Introduction 303

Classification and Risk Factors 304

Microbiology 306

Clinical Features 306

Laboratory Investigation 307

Imaging Procedures 309

Management 309

Instructive Cases 317

References 320

Chapter 21 Implant-Associated Vertebral Osteomyelitis 325
Todd J. Kowalski

Introduction 325

Epidemiology, Risk Factors, and Preventive Measures 326

Microbiology 327

Clinical Features 331

Diagnostic Procedures 332

Management 333

Instructive Cases 339

References 341

Chapter 22 Postoperative Sternal Osteomyelitis 347
Parham Sendi, Örjan Friberg, Mihai A. Constantinescu, and Lars Englberger

Introduction 347

Risk Factors 348

Microbiology 351

Clinical Features 352

Laboratory Investigation 354

Imaging Procedures 355

Management 356

Instructive Cases 360

References 362

Index 367