Orthopedic infections, ranging from superficial soft-tissue infections to complex cases of osteomyelitis and septic arthritis, present significant diagnostic and therapeutic challenges. Prompt recognition and effective management are crucial to prevent complications such as chronic pain, functional loss, and systemic spread. This chapter provides a comprehensive overview of the diagnostic strategies and general principles in the management of orthopedic infections. Emphasis is placed on systematic clinical evaluation, utilization of laboratory investigations (such as CRP, ESR, and blood cultures), and advanced imaging modalities including MRI and PET-CT. The role of microbiological testing through culture, sensitivity, and molecular diagnostics is discussed in guiding targeted antibiotic therapy. Surgical interventions, ranging from debridement to staged procedures with antibiotic-loaded cement spacers, are outlined based on the chronicity and severity of infection. Multidisciplinary collaboration involving orthopedic surgeons, infectious disease specialists, microbiologists, and plastic surgeons is highlighted as essential for optimizing patient outcomes. Preventive strategies, including preoperative optimization, prophylactic antibiotics, and sterile techniques, are also emphasized to minimize the risk of infection.

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Diagnostic Approaches and General Principles of Management of Orthopedic Infections

  • Vivek P. Ksheerasagar,
  • Vijay G. Goni

摘要

Orthopedic infections, ranging from superficial soft-tissue infections to complex cases of osteomyelitis and septic arthritis, present significant diagnostic and therapeutic challenges. Prompt recognition and effective management are crucial to prevent complications such as chronic pain, functional loss, and systemic spread. This chapter provides a comprehensive overview of the diagnostic strategies and general principles in the management of orthopedic infections. Emphasis is placed on systematic clinical evaluation, utilization of laboratory investigations (such as CRP, ESR, and blood cultures), and advanced imaging modalities including MRI and PET-CT. The role of microbiological testing through culture, sensitivity, and molecular diagnostics is discussed in guiding targeted antibiotic therapy. Surgical interventions, ranging from debridement to staged procedures with antibiotic-loaded cement spacers, are outlined based on the chronicity and severity of infection. Multidisciplinary collaboration involving orthopedic surgeons, infectious disease specialists, microbiologists, and plastic surgeons is highlighted as essential for optimizing patient outcomes. Preventive strategies, including preoperative optimization, prophylactic antibiotics, and sterile techniques, are also emphasized to minimize the risk of infection.