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Open research questions in Orthopedic Infections and Treatments

514 gap statements mined from Orthopedic Infections and Treatments papers in our 7.9M-paper local library, which holds 2,130 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • Limited data on Girdlestone resection arthroplasty performed without an antibiotic-loaded spacer. Limited knowledge on the use of prolene mesh in spacer-free Girdlestone resection arthroplasty.

    Spacer-free but prolene mesh-supported girdlestone resection arthroplasty achieves reliable ınfection eradication and pain relief in high-risk patients: 5-year outcomes · 2026 · DOI

  • The role of antibiotic-loaded calcium sulphate beads in DAIR is controversial. There is a lack of studies comparing the outcomes of DAIR and DAPRI for acute PJI.

    Antibiotic-loaded calcium sulphate beads in in debridement, antibiotics, and implant retention (DAIR) for acute hip and knee periprosthetic joint infection: a retrospective comparative cohort study · 2026 · DOI

  • Further studies could investigate the relationship between shingles and complications following other types of surgery. Research could focus on identifying factors that contribute to the development of shingles in patients undergoing shoulder arthroplasty. Studies could examine the impact of shingles on patient outcomes in different populations.

    Perioperative shingles diagnosis does not influence prosthetic joint infection rates after shoulder arthroplasty · 2026 · DOI

  • The association between shingles and postoperative complications following shoulder arthroplasty is unknown. Prior studies have not investigated the relationship between shingles and postoperative complications after shoulder arthroplasty.

    Perioperative shingles diagnosis does not influence prosthetic joint infection rates after shoulder arthroplasty · 2026 · DOI

  • The study involved a limited number of bacterial strains. The study did not investigate the long-term effects of antibiotic-loaded hydrogels. The study used a covalently cross-linked HA hydrogel formulation whose interaction with osteogenic cells has not previously been characterised.

    Effects of antibiotics encapsulated in hyaluronic acid hydrogels on different osteogenic cells and bacteria · 2026 · DOI

  • The evidence base for diagnostic thresholds of serum and synovial host-response biomarkers for PJI in patients with inflammatory arthritis is limited. Recent studies have expanded the evidence base, but a systematic review and diagnostic test accuracy meta-analysis are needed to evaluate the diagnostic performance of these biomarkers.

    Diagnostic performance and reported diagnostic thresholds of serum and synovial host-response biomarkers for periprosthetic joint infection in patients with inflammatory arthritis: protocol for a systematic review and diagnostic test accuracy meta-analysis · 2026 · DOI

  • High production costs and limited stability of novel therapies. The formation of biofilms on joint prosthetics increases antibiotic resistance. The need for further research and optimization to fully realize the potential of these treatments for MRSA-PJI.

    Novel Therapies for Prosthetic Joint Infections Caused by Methicillin-Resistant Staphylococcus aureus · 2025 · DOI

  • Limited sample size. Retrospective study design. Difficulty in maintaining soft-tissue balance and alignment without an antibiotic-loaded spacer.

    Spacer-free but prolene mesh-supported girdlestone resection arthroplasty achieves reliable ınfection eradication and pain relief in high-risk patients: 5-year outcomes · 2026 · DOI

  • Although data are limited, surgeon expertise and surgical technique likely influence outcomes.

    A standardized surgical technique for DAIR improves treatment success rates in acute periprosthetic knee infection · 2026 · DOI

  • This review aims to determine whether commonly used and emerging host-response biomarkers retain adequate diagnostic performance in inflammatory arthritis, identify candidate population-specific thresholds that require prospective external validation, and clarify where evidence is insufficient for clinical implementation.

    Diagnostic performance and reported diagnostic thresholds of serum and synovial host-response biomarkers for periprosthetic joint infection in patients with inflammatory arthritis: protocol for a systematic review and diagnostic test accuracy meta-analysis · 2026 · DOI

  • Broad-range 16S ribosomal ribonucleic acid (RNA) gene polymerase chain reaction (PCR) with sequencing has been proposed as an adjunct to culture; however, its diagnostic performance in revision shoulder arthroplasty using periprosthetic tissue remains incompletely defined.

    Clinical utility of 16S ribosomal ribonucleic acid gene polymerase chain reaction versus tissue culture in shoulder periprosthetic joint infections · 2026 · DOI

  • This proof-of-concept study demonstrates the enhanced antimicrobial activity of PMMA with honey in vitro and warrants further investigation in preclinical models of osteomyelitis.

    Synthesis and Characterization of an Antimicrobial Honey-based Composite Bone Cement · 2026 · DOI

  • Little is known about the frequency of persistent infections, mechanical complications, and functional results in patients with retained spacers.

    What Is the Fate of Retained Antibiotic Spacers After First-stage Revision for Periprosthetic Joint Infection? · 2026 · DOI

  • The available evidence is scarce and somewhat contradictory, so new studies are required.

    Does a Prior Unsuccessful DAIR Increase the Risk of Reinfection After a Two-stage Revision for Periprosthetic Joint Infection? Results of a Multicenter Case-control Study · 2026 · DOI

  • Limited data are available on using oritavancin for bone and joint infections caused by VRE, both for treatment (therapy to eliminate active infection) and suppressive antimicrobial therapy (long-term antibiotic administration to prevent infection recurrence in patients at high risk for that complication).

    Can Oritavancin Be Used for Treatment and/or Suppressive Antimicrobial Therapy of Bone and Joint Infections Caused by Vancomycin-resistant Enterococcus faecium? · 2025 · DOI

  • However, the prevalence and association of bacteremia in chronic PJI remain unknown.

    How Often Does Bacteremia Occur in Patients With Chronic Periprosthetic Joint Infection? A Prospective, Observational Study · 2025 · DOI

  • Numerous criterion-based definitions of periprosthetic joint infection (PJI) with differing criteria and point systems have been published, but the frequency of their use or application to study methods in publications on PJI has not been evaluated.

    Discrepancies in Periprosthetic Joint Infection Diagnostic Criteria Reporting and Use: A Scoping Review and Call for a Standard Reporting Framework · 2025 · DOI

  • Although previous studies have identified risk factors for overall and late-onset PJI, limited research has focused specifically on infections occurring within the immediate 90-day postoperative period, a time frame critical for assessing surgical quality and early recovery outcomes.

    Factors That Increase the Risk of Prosthetic Joint Infection Within 90 Days After THA and TKA: A Nationwide Population-based Study · 2025 · DOI

  • Limited effectiveness of systemically administered antibiotics in achieving bactericidal concentrations within biofilm on retained implant surfaces. Difficulty in achieving statistically significant reduction in septic failure with DAPRI.

    Antibiotic-loaded calcium sulphate beads in in debridement, antibiotics, and implant retention (DAIR) for acute hip and knee periprosthetic joint infection: a retrospective comparative cohort study · 2026 · DOI

  • Nevertheless, the influence of trauma biomechanics on infection development and microbial community dynamics is poorly studied.

    Mechanism of injury influences early microbial trajectories and infection pathways in open fractures: A 16S rDNA study · 2026 · DOI

  • We used the CDC definition of infection, which classified a superficial infection as an infection limited to the skin and a deep infection as an infection beneath the incision in the muscle and surrounding tissues.

    Can We Validate the Musculoskeletal Infection Society Criteria in Patients Suspected of Infection After Transfemoral Osseointegration Surgery? · 2026 · DOI

  • The study was retrospective - The sample size was limited to 112 patients - No long-term follow-up data…

    Clinical efficacy comparison of Ilizarov bone transport versus Masquelet technique for cierny-mader type Ⅲ-Ⅳ tibial osteomyelitis with large bone defects · 2026 · DOI

  • Investigate the long-term outcomes of both techniques - Compare the cost-effectiveness of both techniques - Explore the application of these techniques in other types of bone…

    Clinical efficacy comparison of Ilizarov bone transport versus Masquelet technique for cierny-mader type Ⅲ-Ⅳ tibial osteomyelitis with large bone defects · 2026 · DOI

  • High production costs, - Limited stability of novel therapies, - Traditional treatment approach for MRSA-PJI has clear limitations, - Surgical intervention is often associated with substantial tissue trauma and prolonged postoperative…

    Novel Therapies for Prosthetic Joint Infections Caused by Methicillin-Resistant Staphylococcus aureus · 2025 · DOI

  • Results after debridement, antibiotics and implant retention (DAIR) for acute periprosthetic knee joint infections (PJIs) vary widely.

    A standardized surgical technique for DAIR improves treatment success rates in acute periprosthetic knee infection · 2026 · DOI

Most-cited papers in Orthopedic Infections and Treatments

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Open questions raised by papers listed on this page include: (1) There is a lack of studies comparing the outcomes of DAIR and DAPRI for acute PJI (“Antibiotic-loaded calcium sulphate beads in in debridement, antibiotics, and…”, 2026); (2) Further studies could investigate the relationship between shingles and complications following other types of surgery (“Perioperative shingles diagnosis does not influence prosthetic joint infection…”, 2026); (3) Recent studies have expanded the evidence base, but a systematic review and diagnostic test accuracy meta-analysis are needed to evaluate the diagnostic performance of these biomarkers (“Diagnostic performance and reported diagnostic thresholds of serum and synovial…”, 2026); (4) Little is known about the frequency of persistent infections, mechanical complications, and functional results in patients with retained spacers (“What Is the Fate of Retained Antibiotic Spacers After First-stage Revision for…”, 2026); (5) The available evidence is scarce and somewhat contradictory, so new studies are required (“Does a Prior Unsuccessful DAIR Increase the Risk of Reinfection After a…”, 2026). 514 gap statements have been mined from Orthopedic Infections and Treatments papers in our 7.9M-paper local library, which holds 2,130 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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