# EPIDEMIOLOGY

EPIDEMIOLOGY

The pattern of  bone infection is changing, and the incidence is increasing. Bone and joint infection a ff ects around 1 per 10 /uni00A0 000 children across the world. Inadequate initial treatment generates chronic infections in up to one-third of  cases. In the developed world, bone infection is frequently seen after injury or surgery (contiguous focus osteomyelitis) and is often implant related ( Figure 43.1 ). Increasing life expectancy , obesity , medical comorbidities (diabetes, peripheral vascular disease, immunocompromise) and increased rates of  bone surgery contribute to a group of  patients with increased susceptibility to infection. Prosthetic joint replacement is a highly successful therapy for joint disease but is complicated by infection in at least 1% of  cases. It was estimated that joint replacement generated more than 70 /uni00A0 000 new cases of  prosthetic joint infection (PJI) in the USA in 2020. These are di ffi cult and expensive to treat, myelos , - - - 

Treatment of infection of native bones and joints
•
Treatment of fracture-related and prosthetic joint
•
infections
Figure 43.1
This open fracture of the tibia was treated with internal
/f_i
xation using a plate. An early fracture-related infection developed,
with skin breakdown and exposure of the metalwork.

fracture has decreased but increased use of  internal fixation has increased the prevalence of  post-traumatic bone infection overall. This will produce a significant economic burden for healthcare providers in the future. Summary box 43.1 Epidemiology of bone infection /uni25CF /uni25CF /uni25CF 

Bone and joint infections from haematogenous spread remain
common worldwide
The increased use of implants for joint replacement and
fracture
/f_i
xation are an important source of new infections
Immunocompromised patients are another increasing source
(e.g. diabetes, cancer treatment)

EPIDEMIOLOGY

The pattern of  bone infection is changing, and the incidence is increasing. Bone and joint infection a ff ects around 1 per 10 /uni00A0 000 children across the world. Inadequate initial treatment generates chronic infections in up to one-third of  cases. In the developed world, bone infection is frequently seen after injury or surgery (contiguous focus osteomyelitis) and is often implant related ( Figure 43.1 ). Increasing life expectancy , obesity , medical comorbidities (diabetes, peripheral vascular disease, immunocompromise) and increased rates of  bone surgery contribute to a group of  patients with increased susceptibility to infection. Prosthetic joint replacement is a highly successful therapy for joint disease but is complicated by infection in at least 1% of  cases. It was estimated that joint replacement generated more than 70 /uni00A0 000 new cases of  prosthetic joint infection (PJI) in the USA in 2020. These are di ffi cult and expensive to treat, myelos , - - - 

Treatment of infection of native bones and joints
•
Treatment of fracture-related and prosthetic joint
•
infections
Figure 43.1
This open fracture of the tibia was treated with internal
/f_i
xation using a plate. An early fracture-related infection developed,
with skin breakdown and exposure of the metalwork.

fracture has decreased but increased use of  internal fixation has increased the prevalence of  post-traumatic bone infection overall. This will produce a significant economic burden for healthcare providers in the future. Summary box 43.1 Epidemiology of bone infection /uni25CF /uni25CF /uni25CF 

Bone and joint infections from haematogenous spread remain
common worldwide
The increased use of implants for joint replacement and
fracture
/f_i
xation are an important source of new infections
Immunocompromised patients are another increasing source
(e.g. diabetes, cancer treatment)

EPIDEMIOLOGY

The pattern of  bone infection is changing, and the incidence is increasing. Bone and joint infection a ff ects around 1 per 10 /uni00A0 000 children across the world. Inadequate initial treatment generates chronic infections in up to one-third of  cases. In the developed world, bone infection is frequently seen after injury or surgery (contiguous focus osteomyelitis) and is often implant related ( Figure 43.1 ). Increasing life expectancy , obesity , medical comorbidities (diabetes, peripheral vascular disease, immunocompromise) and increased rates of  bone surgery contribute to a group of  patients with increased susceptibility to infection. Prosthetic joint replacement is a highly successful therapy for joint disease but is complicated by infection in at least 1% of  cases. It was estimated that joint replacement generated more than 70 /uni00A0 000 new cases of  prosthetic joint infection (PJI) in the USA in 2020. These are di ffi cult and expensive to treat, myelos , - - - 

Treatment of infection of native bones and joints
•
Treatment of fracture-related and prosthetic joint
•
infections
Figure 43.1
This open fracture of the tibia was treated with internal
/f_i
xation using a plate. An early fracture-related infection developed,
with skin breakdown and exposure of the metalwork.

fracture has decreased but increased use of  internal fixation has increased the prevalence of  post-traumatic bone infection overall. This will produce a significant economic burden for healthcare providers in the future. Summary box 43.1 Epidemiology of bone infection /uni25CF /uni25CF /uni25CF 

Bone and joint infections from haematogenous spread remain
common worldwide
The increased use of implants for joint replacement and
fracture
/f_i
xation are an important source of new infections
Immunocompromised patients are another increasing source
(e.g. diabetes, cancer treatment)