Aging and Infection in Bone and Joint Diseases: Mechanistic Insights and Clinical Translation

The field of orthopedics is increasingly confronting the dual challenges of degenerative and infectious bone and joint diseases in an aging global population. Degenerative conditions such as osteoarthritis and osteoporosis diminish tissue homeostasis and regenerative capacity, while infections such as osteomyelitis and periprosthetic joint infections compromise skeletal integrity through microbial invasion and chronic inflammation. Recent clinical evidence indicates that these disorders frequently coexist in elderly patients, forming a destructive cycle in which age-related degeneration predisposes to infection, and infection further accelerates degenerative damage. Current studies reveal that aging-associated vascular deficits, immunosenescence, and altered bone metabolism create a permissive microenvironment for pathogen colonization and biofilm persistence. Despite growing awareness of their interconnection, fundamental questions remain regarding the shared molecular pathways linking aging, immunity, and microbial virulence in skeletal tissues. Recent applications of multi omics, artificial intelligence, and advanced biomaterials are beginning to illuminate new mechanistic insights, yet the translation of these findings into effective clinical interventions remains limited. A more integrated research approach is urgently needed to bridge these gaps and advance the field toward comprehensive prevention and therapy.

This Research Topic aims to elucidate the common biological and pathological foundations that underline the intertwined processes of aging and infection in bone and joint diseases. Specifically, it seeks to identify key molecular and cellular mechanisms that mediate susceptibility to infection in aged musculoskeletal tissues, characterize the interplay between degenerative and inflammatory pathways, and develop innovative strategies for diagnosis, regeneration, and infection control. By fostering collaboration among orthopedists, immunologists, microbiologists, and materials scientists, the topic aspires to transform fragmented research into a coherent framework that supports mechanistic understanding and clinical translation. Ultimately, it endeavors to inspire novel therapeutic paradigms that can mitigate age-related fragility while bolstering resistance against infection.

To gather further insight into the intersection of musculoskeletal aging and infection, we welcome articles addressing, but not limited to, the following themes:

• Mechanistic studies and clinical management of age-related bone and joint diseases, including osteoarthritis and osteoporosis.
• Precision diagnosis and treatment innovations for bone and joint infections, with emphasis on antimicrobial resistance, biofilm disruption, and reconstruction of infected bone.
• Cross-system interactions between skeletal, immune, metabolic, and microbial networks influencing susceptibility and healing.
• Integrative analyses using multi-omics and AI-assisted modeling to map shared molecular signatures of degeneration and infection.
• Frontier technologies and multidisciplinary strategies such as biomaterials, tissue engineering, organoid and ex vivo models, and gene editing for translational research.