Editorial Comment: Symposium: 2012 Musculoskeletal Infection Society
Interdisciplinary academic collaborations, reviews, and discussions are the mainstay of the Musculoskeletal Infection Society (MSIS). The MSIS was founded in 1989 as a multidisciplinary educational and scientific forum for clinicians and scientists. Our mission is to advance knowledge in the field of musculoskeletal infection and its treatment by: (1) educating clinician and research members; (2) educating the medical community and the general public; and (3) promoting and maintaining professional standards in order to provide the best professional care to patients with musculoskeletal infection.
The 22nd Annual Open Scientific Meeting of the MSIS, held on August 10 and 11, 2012 in San Antonio, Texas, certainly fulfilled these goals. As modern medicine evolves, infection continues to cause decreased patient satisfaction, increased costs, and morbidity and mortality. Prosthetic joint infections garnered significant interest at our meeting last year. Many of this symposium’s papers are focused on this topic and will enhance our understanding of diagnosis, treatment, prevention, incidence, and outcomes for prosthetic joint infection.
Two-stage exchange for prosthetic joint infection is considered acceptable in the United States. However, one-stage exchange is the preferred method to treat prosthetic joint infection in parts of Europe. The lessons from one-stage exchange provide insight into the importance of augmenting the local environment to optimize systemic host factors and response in controlling prosthetic joint infection. A core principle of infection surgery is focused on decreasing the biological burden at the surgical site in order to positively modulate the systemic and local immune response to the infection. This concept of surgery as an immunomodulatory technique is also reflected in the other papers in this symposium.
Antimicrobial therapy is another adjunct to treating infection. Yet, the systemic side effects of antibiotics are well recognized. A large part of the symposium highlights local methods, including prevention at the surgical site using presurgical skin decontamination techniques and treatment using local antibiotic delivery. Different carriers and concentrations influence dosage and toxicity. Both systemic and local methods form the mainstay of infection prevention and treatment.