Bone and periprosthetic joint infections in older adults

Abstract

Most bone and joint infections are more prevalent in older adults, mainly because of their decreasing host defence and their increasing comorbidity. The main challenge is rapid diagnosis of such infections, because they often manifest with only subtle signs and symptoms in older adults. In this population, the prevalence of vertebral osteomyelitis, diabetic foot osteomyelitis, pressure ulcer osteomyelitis, and periprosthetic joint infections is increasing. For all these infections, rapid diagnostic work-up is needed, because prognosis, including the functional outcome, depends on early and adequate treatment. However, in older adults, quality of life is also crucial. Therefore, in frail individuals, a palliative procedure (e.g. lifelong suppressive therapy) should be sometimes preferred to curative treatment requiring burdening surgical interventions.