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Marjan Wouthuyzen-Bakker Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands

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Introduction Historically, cultures are considered as the gold standard in diagnosing any type of infection. However, cultures can be negative in many infectious diseases, including periprosthetic joint infections (PJI), in particular when a

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Martin McNally The Oxford Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK

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Geertje Govaert Department of Trauma Surgery, University of Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands

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Maria Dudareva The Oxford Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK

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Mario Morgenstern Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Switzerland

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Willem-Jan Metsemakers Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium

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Introduction Successful treatment of a fracture is aimed at promoting bone healing and good functional recovery with the avoidance of complications which may impair function or prolong treatment. When an infection occurs, this can be a

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Ricardo Sousa Department of Orthopaedics, Centro Hospitalar Universitário do Porto, Porto, Portugal
Porto Bone and Joint Infection Group (GRIP), Centro Hospitalar Universitário do Porto and Grupo TrofaSaude, Portugal

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André Carvalho Department of Orthopaedics, Centro Hospitalar Universitário do Porto, Porto, Portugal

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Ana Cláudia Santos Porto Bone and Joint Infection Group (GRIP), Centro Hospitalar Universitário do Porto and Grupo TrofaSaude, Portugal
Department of Microbiology, Centro Hospitalar Universitário do Porto, Porto, Portugal

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Miguel Araújo Abreu Porto Bone and Joint Infection Group (GRIP), Centro Hospitalar Universitário do Porto and Grupo TrofaSaude, Portugal
Department of Microbiology, Centro Hospitalar Universitário do Porto, Porto, Portugal

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Introduction Infection is a serious complication that affects all fields of orthopaedics and traumatology. Even though in certain specific conditions infection can be assumed even in the absence of isolated pathogens, adequate microbiological

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Abdel Rahim Elniel Leeds Teaching Hospitals Trust, UK

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Peter V. Giannoudis Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals, University of Leeds, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, UK

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consideration for treatment should be guided by the individual clinical picture and established standards. Principles of management The fundamental objectives of treatment are to manage the soft-tissue injury, minimize the risk of infection, stabilize

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Sylvain Steinmetz Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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Diane Wernly Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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Kevin Moerenhout Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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Andrej Trampuz Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany

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Olivier Borens Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland

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Introduction Infection after fracture fixation (IAFF) in orthopaedic surgery is a dreaded complication, leading to non-union, loss of function, and even amputation. It is not only a source of morbidity and mortality, 1 but it also brings

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Razvan Ene Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
Bucharest Emergency Clinical Hospital, Romania

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Mihai Nica Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Dragos Ene Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
Bucharest Emergency Clinical Hospital, Romania

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Adrian Cursaru Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Catalin Cirstoiu Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Introduction Infection associated with orthopaedic implants or surgical site infections is a deleterious complication, resulting in considerable rates of morbidity and mortality. Furthermore, management of this complication is incredibly

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Andreas F. Mavrogenis First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Panayiotis D. Megaloikonomos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Thekla Antoniadou First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Vasilios G. Igoumenou First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Georgios N. Panagopoulos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Leonidas Dimopoulos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Konstantinos G. Moulakakis Department of Vascular Surgery, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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George S. Sfyroeras Department of Vascular Surgery, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Andreas Lazaris Department of Vascular Surgery, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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- 16 Half of DFUs occur in the plantar surface and the other half in other areas of the foot. Neuropathy, peripheral artery disease (PAD), deformities of the foot related to motor neuropathy and minor foot trauma, infection and osteomyelitis are

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Joseph Genevière Faculty of Medicine, University of Geneva, Geneva, Switzerland
Co-first authors and equal contributors

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Shawna McCallin Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland
Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
Co-first authors and equal contributors

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Angela Huttner Faculty of Medicine, University of Geneva, Geneva, Switzerland
Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland

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Truong-Thanh Pham Faculty of Medicine, University of Geneva, Geneva, Switzerland
Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
Division of Orthopaedics and Trauma Surgery, Bone Infection Unit, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland

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Domizio Suva Faculty of Medicine, University of Geneva, Geneva, Switzerland
Division of Orthopaedics and Trauma Surgery, Bone Infection Unit, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland

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Introduction Bone and joint infections include any infection of the bone (osteomyelitis), joint (septic arthritis) or implants related to these structures (periprosthetic joint infections [PJI], fracture-related infections [FRI] involving

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Luke Turley Department of Orthopaedics, Midland Regional Hospital Tullamore, Tullamore, Ireland

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Ian Barry Department of Plastic Surgery, Royal Perth Hospital, Perth, Western Australia, Australia

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Eoin Sheehan Department of Orthopaedics, Midland Regional Hospital Tullamore, Tullamore, Ireland

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tibial shaft fractures are associated with high rates of complications including malunion, non-union and infection ( 5 , 6 ). The severity of the soft tissue injury associated with open fractures has been considered significant for many years. In 1976

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Carsten Perka Center for Musculoskeletal Surgery, Charité Medical University Center, Berlin, Germany

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Maziar Mohaddes Hässleholms Hospital, Region Skåne, Hässleholm, Sweden
Orthopedics, Faculty of Medicine, Department of Clinical Sciences, Lund University, Malmö, Sweden

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Luigi Zagra Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

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Axel Ekkernkamp BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
BG Kliniken – Klinikverbund der gesetzlichen Unfallversicherung gGmbH, Berlin, Germany

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Niklas Keller Harding Center for Risk Literacy, University of Potsdam, Faculty of Health Sciences, Potsdam, Germany

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Dirk Stengel BG Kliniken – Klinikverbund der gesetzlichen Unfallversicherung gGmbH, Berlin, Germany

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/or any sort of polyethylene liners. This was operationalized as follows: (i) lower overall revision and/or higher component survival rates, (ii) lower revision rates for infection, and (iii) improved patient-reported function and/or quality of life, at

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