Managing Infections in Orthopedic Surgery: From Surgical Strategy to Innovative Antimicrobial Therapeutics

Infections remain among the most devastating complications in orthopedic surgery, particularly with the global rise in joint arthroplasties and complex fixation procedures. The presence of foreign materials—such as prostheses and fixation hardware—significantly elevates the risk of persistent infection due to the ability of pathogenic bacteria to adhere, form resilient biofilms, and evade host defenses. Managing these complications, alongside bone-centered pathologies like chronic osteomyelitis, presents a formidable clinical and scientific challenge that demands a highly coordinated, multidisciplinary approach.

At the clinical level, established international guidelines often leave room for debate regarding the optimal therapeutic pathway, including single- vs. two-stage revision, reconstruction strategies, and orthoplastic management for soft-tissue preservation. Concurrently, the rise of multidrug-resistant (MDR) pathogens, driven by widespread antibiotic utilization, has severely compromised standard prophylactic and therapeutic regimens. This has accelerated the search for alternative antimicrobial strategies, such as phage therapy, anti-biofilm agents, and novel drug-delivery systems, though clinical translation remains an ongoing area of investigation.

This Research Topic aims to bridge the gap between bench and bedside by collecting scientific evidence on periprosthetic joint infections and osteomyelitis—spanning from experimental microbiology to surgical management and long-term patient outcomes. By cross-listing Frontiers in Surgery and Frontiers in Cellular and Infection Microbiology, we provide a unified platform for orthopedic surgeons, clinical microbiologists, and infectious disease specialists to share insights on overcoming bone and joint infections.

We welcome submissions that address, but are not limited to, the following themes:

• Innovative surgical techniques, staging protocols, and reconstructive orthoplastic strategies for managing osteomyelitis and periprosthetic joint infections.

• Characterization of bacterial adhesion, biofilm dynamics, and host-pathogen interactions on implant surfaces.

• Surveillance of antimicrobial resistance patterns, genomic variants of pathogens, and stewardship programs within orthopedic and surgical units.

• Preclinical and clinical evaluation of novel antimicrobial therapies, including bacteriophage therapeutics, bone-targeted drug delivery systems, and biomaterial surface modifications.

• Diagnostic advancements in detecting implant-associated infections, including molecular, imaging, and biomarker assays.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Curriculum, Instruction, and Pedagogy
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Curriculum, Instruction, and Pedagogy
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: Osteomyelitis, Orthopedic surgery, Biofilms, Antimicrobial Resistance, Bacteriophage Therapy

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.