Clinical practice variation in orthopedic infections: insights from the Musculoskeletal Infection Society (MSIS) and European Bone and Joint Infection Society (EBJIS) survey, 2023

In 2023, members of the Musculoskeletal Infection Society (MSIS) and the European Bone and Joint Infection Society (EBJIS) participated in a survey assessing their approaches to prevention, diagnosis, and management of orthopedic infections. The survey revealed notable differences between the two societies in several key areas, including requirements for smoking cessation prior to elective surgery, use of pre-operative skin and nasal antiseptics, application of local antibiotics in non-infected cases, preferred definitions of periprosthetic joint infection (PJI), use of alpha-defensin testing in pre-operative diagnosis, application of sonication of explanted implants, number of tissue samples obtained for microbiological and histological analysis, use of sequence-based diagnostics, and duration of antibiotic therapy. These findings demonstrate substantial variability in clinical practice among international experts in the field, highlighting the need for further research and consensus to harmonize strategies in orthopedic infection care.