Close-up of a 3D-printed joint prosthesis

Teaching and research

Research

Teaching and research is a central component of our daily work. Medical knowledge is constantly increasing, technical progress is accelerating - today it is a matter of course that we work together and invest in education and research.


The team at the Center for Musculoskeletal Infections strives to continuously adapt treatment concepts in line with the latest research and to pass this on.
From diagnostics and therapy to the effects of musculoskeletal infections on daily life, we are interested in all the correlations and new findings that have an influence on the successful treatment of our patients.


We may therefore ask you as a patient to participate in our surveys or research projects. This has no direct advantage or disadvantage for you personally, but your contribution is extremely important for future patients and for the further development of our treatment concepts.

Find out more about our current projects below:

As part of value-based healthcare, we will ask you about your general health and quality of life during your stay in hospital and afterwards (after 6 weeks, 3 months, 1 year and 2 years). The information you provide enables us to better assess your personal state of health and adapt your individual treatment accordingly. On the other hand, we can also draw conclusions for the adaptation of our treatment concepts.
Participation in the survey is voluntary, but extremely valuable for us.

Find out more about the benefits of value-based treatment in the "gesundheit heute" program using the example of a patient with shoulder pain in our orthopaedics clinic at Bethesda Hospital:
https://www.unispital-basel.ch/medien/publikationen/gesundheit-heute/wertebasierte-behandlung-bei-schulterschmerzen/

For further questions about the PROMS measurements:
Mandy Mathys, Study Coordinator, Tel: 061 556 52 79, mandy.mathys@usb.ch

The MID study is an international research project of the University Medical Center Utrecht. Over 2 years, participants are being sought at eight clinics in Europe to test the reliability of the Synovasure® Microbial ID test (MID test) for the detection of infection in artificial joints.



To date, there is no reliable test for the detection of a prosthesis infection. At present, various tests are carried out if a prosthesis infection is suspected. These include a physical examination, a blood test, X-rays and a puncture of the joint to have joint fluid examined in the laboratory. All these examinations provide different results. In current practice, the combination of these examination results provides the orthopaedic surgeon with the diagnosis of a prosthesis infection. However, not all prosthesis infections are detected in this way. In addition, it can take up to 14 days for all the results to be available.
However, the results of the MID test are available after just 48 hours. For these reasons, the research project aims to find out whether the MID test provides reliable evidence of a prosthesis infection.


All patients with a suspected joint prosthesis infection who are scheduled for joint puncture or surgery and who have not yet started antibiotic therapy are eligible to participate.



For further questions about the MID study:
Lea Martin, Medical Assistant/Study Coordinator, Tel. 061 556 59 52, lea.martin@usb.ch

Antibiotics are effective and indispensable drugs for the treatment of life-threatening bacterial infections. However, more and more bacterial pathogens are developing resistance to one or even several antibiotics, making it difficult or even impossible to treat the infection.

There is therefore an urgent need to find new approaches to combat antibiotic-resistant bacteria. However, the development of new drugs usually takes up to 20 years and there are currently hardly any new classes of antibiotics in development.

The National Center of Competence in Research (NCCR) AntiResist is a Swiss-wide research consortium funded by the Swiss National Science Foundation (SNSF). The aim of AntiResist is to combat the rapid and global increase and spread of antibiotic resistance and, ideally, to find new approaches to treating infections.

The entire project is designed to run for 12 years. The first part of the project aims to better understand the processes in the body, in particular the bacteria during an infection. To this end, a clinical study will be carried out at the USB over 4 years to obtain sample material, which will then be examined and researched.
We at the Center for Musculoskeletal Infections are involved in the area of deep-seated infections. Infected tissue that is removed during an operation and is not required is made available to the researchers.

Further information on the NCCR AntiResist project (currently only available in English):
https://www.nccr-antiresist.ch/en/

For further questions: PD Dr. Richard Kühl, Subinvestigator/Chief Physician Infectiology, Tel: 061 328 66 61, richardalexander.kuehl@usb.ch

Diagnosing periprosthetic hip joint infection with new-generation 0.55T MRI
Jan Plesniar , Hanns-Christian Breit , Martin Clauss , Ricardo Donners 
European Journal of Radiology Jul 2024 Link

The European Bone and Joint Infection Society Definition of Periprosthetic Joint Infection is meaningful in clinical practice - a multicentric validation study with comparison to previous definitions
Sousa R, Ribau A, Alfaro P, Burch MA, Ploegmakers JJW, McNally M, Clauss M, Wouthuyzen-Bakker M, Soriano A.
Acta Orthop 2023 Jan 2023;94:8-18 Link

Management of acute periprosthetic knee infection: Superior infection eradication and implant retention after open vs. arthroscopic DAIR
Bartsch A, Krenn P, Lubberts P, Morgenstern M, Pagensteert G, Clauss M
Archives Orthopedics Trauma Surgery Jan 2023 Link

Septic arthritis
Frank FA, Peduzzi N, Brugger R, Morgenstern M, Cadosch D, Clauss M
Therapeutic Review 80(1), 39-44 Feb 2023 Link

Fracture-related infection

T. Fintan Moriarty, Willem-Jan Metsemakers, Mario Morgenstern, Marloes I. Hofstee, Alejandro Vallejo Diaz, James E. Cassat, Britt Wildemann, Melissa Depypere, Edward M. Schwarz & R. Geoff Richards Nature Reviews Disease Primers volume 8, Article number: 67 (2022) Link

Perioperative myocardial injury and mortality after revision surgery for orthopaedic device-related infection.

Kvarda P, Puelacher C, Clauss M, Kuehl R, Gerhard H, Mueller C, Morgenstern M.
Bone Joint J. 2022 Jun;104-B(6):696-702. doi: 10.1302/0301-620X.104B6.BJJ-2021-1486.R1. PubMed PMID: 35638215. Link

Management of fracture-related infection in low resource settings: how applicable are the current consensus guidelines?

Tissingh EK, Marais L, Loro A, Bose D, Ferguson J, Morgensten M, McNally M.
EFORT Open Rev. 2022 May 31;7(6):422-432. doi: 10.1530/EOR-22-0031. Review. PubMed PMID: 35638596; PubMed Central PMCID: PMC9257735. Link

Patient- and procedure-related factors in the pathophysiology of perioperative myocardial infarction/injury.
Gueckel J, Puelacher C, Glarner N, Gualandro DM, Strebel I, Zimmermann T, Arslani K, Hidvegi R, Liffert M, Genini A, Marbot S, Schlaepfer M, Steiner LA, Bolliger D, Lampart A, Gürke L, Kindler C, Schären S, Osswald S, Clauss M, Rikli D, Lurati Buse G, Mueller C.

Int J Cardiol. 2022 Apr 15;353:15-21. doi: 10.1016/j.ijcard.2022.01.015. Epub 2022 Jan 11. PubMed PMID: 35026340.Link

Methylene blue for the diagnosis of a sinus tract in periprosthetic knee joint infection.

Heinrich SM, Sendi P, Clauss M.
J Bone Jt Infect. 2021;6(9):423-424. doi: 10.5194/jbji-6-423-2021. eCollection 2021. PubMed PMID: 34804777; PubMed Central PMCID: PMC8600461. Link

Soft-tissue reconstruction in lower-leg fracture-related infections: An orthoplastic outcome and risk factor analysis.

Müller SLC, Morgenstern M, Kuehl R, Muri T, Kalbermatten DF, Clauss M, Schaefer DJ, Sendi P, Osinga R.
Injury. 2021 Nov;52(11):3489-3497. doi: 10.1016/j.injury.2021.07.022. Epub 2021 Jul 16. PubMed PMID: 34304885. Link

Definition of long-bone nonunion: A scoping review of prospective clinical trials to evaluate current practice.

Wittauer M, Burch MA, McNally M, Vandendriessche T, Clauss M, Della Rocca GJ, Giannoudis PV, Metsemakers WJ, Morgenstern M.
Injury. 2021 Nov;52(11):3200-3205. doi: 10.1016/j.injury.2021.09.008. Epub 2021 Sep 10 Review. PubMed PMID: 34531088. Link

Bone infection: a clinical priority for clinicians, scientists and educators.

Moriarty TF, Muthukrishnan G, Daiss JL, Xie C, Nishitani K, Morita Y, Awad H, de Mesy Bentley KL, Masters E, Bui T, Yan M, Owen J, Mooney B, Gill S, Puetzler J, Wenke JC, Morgenstern M, Metsemakers WJ, Noll C, Joeris A, Richards RG, Schwarz EM, Kates SL.
Eur Cell Mater. 2021 Oct 18;42:312-333. doi: 10.22203/eCM.v042a21. Review. PubMed PMID: 34661245. Link

What is the diagnostic value of the Centers for Disease Control and Prevention criteria for surgical site infection in fracture-related infection?

Sliepen J, Onsea J, Zalavras CG, Depypere M, Govaert GAM, Morgenstern M, McNally MA, Verhofstad MHJ, Obremskey WT, IJpma FFA, Metsemakers WJ
Injury. 2021 Oct;52(10):2879-2885. doi: 10.1016/j.injury.2021.08.009. Epub 2021 Aug 10. PubMed PMID: 34412852. Link


Providing an Evidence Base for Tissue Sampling and Culture Interpretation in Suspected Fracture-Related Infection.

Dudareva M, Barrett LK, Morgenstern M, Atkins BL, Brent AJ, McNally MA.
J Bone Joint Surg Am. 2021 Jun 2;103(11):977-983. doi: 10.2106/JBJS.20.00409. PubMed PMID: 33764925. Link

Fracture-related infection.

Baertl S, Metsemakers WJ, Morgenstern M, Alt V, Richards RG, Moriarty TF, Young K.
Bone Joint Res. 2021 Jun;10(6):351-353. doi: 10.1302/2046-3758.106.BJR-2021-0167.R1. PubMed PMID: 34076501; PubMed Central PMCID: PMC8242679. Link

The Impact of Surgical Strategy and Rifampin on Treatment Outcome in Cutibacterium Periprosthetic Joint Infections.

Kusejko K, Auñón ÁJost B, Natividad B, Strahm C, Thurnheer C, Pablo-Marcos D, Slama D, Scanferla G, Uckay I, Waldmann I, Esteban J, Lora-Tamayo J, Clauss M, Fernandez-Sampedro M, Wouthuyzen-Bakker M, Ferrari MC, Gassmann N, Sendi P, Jent P, Morand PC, Vijayvargiya P, Trebše R, Patel R, Kouyos RD, Corvec S, Kramer TS, Stadelmann VA, Achermann Y.
Clin Infect Dis. 2021 Jun 15;72(12):e1064-e1073. doi: 10.1093/cid/ciaa1839. PubMed PMID: 33300545; PubMed Central PMCID: PMC8427719. Link

When antibiotics fail: a clinical and microbiological perspective on antibiotic tolerance and persistence of Staphylococcus aureus.

Kuehl R, Morata L, Meylan S, Mensa J, Soriano A.J
Antimicrob Chemother. 2020 May 1;75(5):1071-1086. doi: 10.1093/jac/dkz559.PMID: 32016348 Link

The influence of duration of infection on outcome of debridement and implant retention in fracture-related infection.

Morgenstern M, Kuehl R, Zalavras CG, McNally M, Zimmerli W, Burch MA, Vandendriessche T, Obremskey WT, Verhofstad MHJ, Metsemakers WJ.
Bone Joint J. 2021 Feb;103-B(2):213-221. doi: 10.1302/0301-620X.103B2.BJJ-2020-1010.R1. PubMed PMID: 33517743. Link

The influence of biomechanical stability on bone healing and fracture-related infection: the legacy of Stephan Perren.

Foster AL, Moriarty TF, Zalavras C, Morgenstern M, Jaiprakash A, Crawford R, Burch MA, Boot W, Tetsworth K, Miclau T, Ochsner P, Schuetz MA, Richards RG, Metsemakers WJ.
Injury. 2021 Jan;52(1):43-52. doi: 10.1016/j.injury.2020.06.044. Epub 2020 Jun 26. review. PubMed PMID: 32620328. Link

The AO trauma CPP bone infection registry: Epidemiology and outcomes of Staphylococcus aureus bone infection.

Morgenstern M, Erichsen C, Militz M, Xie Z, Peng J, Stannard J, Metsemakers WJ, Schaefer D, Alt V, Søballe K, Nerlich M, Buckley RE, Blauth M, Suk M, Leung F, Barla JD, Yukata K, Qing B, Kates SL.
J Orthop Res. 2021 Jan;39(1):136-146. doi: 10.1002/jor.24804. Epub 2020 Jul 27. PubMed PMID: 32720352; PubMed Central PMCID: PMC7749080. Link

The EBJIS definition of periprosthetic joint infection.

McNally M, Sousa R, Wouthuyzen-Bakker M, Chen AF, Soriano A, Vogely HC, Clauss M, Higuera CA, Trebše R.
Bone Joint J. 2021 Jan;103-B(1):18-25. doi: 10.1302/0301-620X.103B1.BJJ-2020-1381.R1.PMID: 33380199. Link

Orthoplastics in Periprosthetic Joint Infection of the Knee: Treatment Concept for Composite Soft-tissue Defect with Extensor Apparatus Deficiency.

Osinga R, Eggimann MM, Lo SJ, Kühl R, Lunger A, Ochsner PE, Sendi P, Clauss M, Schaefer DJ.
J Bone Jt Infect. 2020;5(3):160-171. doi: 10.7150/jbji.47018. eCollection 2020. PubMed PMID: 32566456; PubMed Central PMCID: PMC7295645. Link

Debridement, Antibiotics and Implant Retention for Hip Periprosthetic Joint Infection: Analysis of Implant Survival after Cure of Infection.

Clauss M, Hunkeler C, Manzoni I, Sendi P.
J Bone Jt Infect. 2020;5(1):35-42. doi: 10.7150/jbji.40924. eCollection 2020. PubMed PMID: 32117688; PubMed Central PMCID: PMC7045527. Link


Definition and diagnosis of fracture-related infection.

McNally M, Govaert G, Dudareva M, Morgenstern M, Metsemakers WJ.
EFORT Open Rev. 2020 Oct;5(10):614-619. doi: 10.1302/2058-5241.5.190072. eCollection 2020 Oct. Review. PubMed PMID: 33204503; PubMed Central PMCID: PMC7608516. Link

Temporal Changes in Patient-Matched Staphylococcus epidermidis Isolates from Infections: towards Defining a 'True' Persistent Infection.

Harris LG, Bodger O, Post V, Mack D, Morgenstern M, Rohde H, Moriarty TF, Wilkinson TS.
Microorganisms. 2020 Sep 30;8(10). doi: 10.3390/microorganisms8101508. PubMed PMID: 33007861; PubMed Central PMCID: PMC7601538. Link

General treatment principles for fracture-related infection: recommendations from an international expert group.

Metsemakers WJ, Morgenstern M, Senneville E, Borens O, Govaert GAM, Onsea J, Depypere M, Richards RG, Trampuz A, Verhofstad MHJ, Kates SL, Raschke M, McNally MA, Obremskey WT.
Arch Orthop Trauma Surg. 2020 Aug;140(8):1013-1027. doi: 10.1007/s00402-019-03287-4. Epub 2019 Oct 29. PubMed PMID: 31659475; PubMed Central PMCID: PMC7351827. Link

Limited diagnostic value of serum inflammatory biomarkers in the diagnosis of fracture-related infections.

Sigmund IK, Dudareva M, Watts D, Morgenstern M, Athanasou NA, McNally MA.
Bone Joint J. 2020 Jul;102-B(7):904-911. doi: 10.1302/0301-620X.102B7.BJJ-2019-1739.R1. PubMed PMID: 32600147. Link

Current Concepts of Osteomyelitis: From Pathologic Mechanisms to Advanced Research Methods.

Hofstee MI, Muthukrishnan G, Atkins GJ, Riool M, Thompson K, Morgenstern M, Stoddart MJ, Richards RG, Zaat SAJ, Moriarty TF.
Am J Pathol. 2020 Jun;190(6):1151-1163. doi: 10.1016/j.ajpath.2020.02.007. Epub 2020 Mar 16 Review. PubMed PMID: 32194053. Link

Musculoskeletal Infection in Orthopaedic Trauma: Assessment of the 2018 International Consensus Meeting on Musculoskeletal Infection.

Obremskey WT, Metsemakers WJ, Schlatterer DR, Tetsworth K, Egol K, Kates S, McNally M.
J Bone Joint Surg Am. 2020 May 20;102(10):e44. doi: 10.2106/JBJS.19.01070. PubMed PMID: 32118653. Link

Pathogenesis and management of fracture-related infection.

Depypere M, Morgenstern M, Kuehl R, Senneville E, Moriarty TF, Obremskey WT, Zimmerli W, Trampuz A, Lagrou K, Metsemakers WJ.
Clin Microbiol Infect. 2020 May;26(5):572-578. doi: 10.1016/j.cmi.2019.08.006. Epub 2019 Aug 22. review. PubMed PMID: 31446152. Link

Evidence-Based Recommendations for Local Antimicrobial Strategies and Dead Space Management in Fracture-Related Infection.

Metsemakers WJ, Fragomen AT, Moriarty TF, Morgenstern M, Egol KA, Zalavras C, Obremskey WT, Raschke M, McNally MA.
J Orthop Trauma. 2020 Jan;34(1):18-29. doi: 10.1097/BOT.0000000000001615. Review. PubMed PMID: 31464858; PubMed Central PMCID: PMC6903381. Link

Recommendations for Systemic Antimicrobial Therapy in Fracture-Related Infection: A Consensus From an International Expert Group.

Depypere M, Kuehl R, Metsemakers WJ, Senneville E, McNally MA, Obremskey WT, Zimmerli W, Atkins BL, Trampuz A.
J Orthop Trauma. 2020 Jan;34(1):30-41. doi: 10.1097/BOT.0000000000001626. PubMed PMID: 31567902; PubMed Central PMCID: PMC6903362. Link

Periprosthetic Joint Infections - An Overview

Clauss M, Cadosch D, Morgenstern M.
Ther Umsch. 2020;77(10):529-534. doi: 10.1024/0040-5930/a001221. PubMed PMID: 33272051.

Diagnosing Fracture-Related Infection: Current Concepts and Recommendations.

Govaert GAM, Kuehl R, Atkins BL, Trampuz A, Morgenstern M, Obremskey WT, Verhofstad MHJ, McNally MA, Metsemakers WJ.
J Orthop Trauma. 2020 Jan;34(1):8-17. doi: 10.1097/BOT.0000000000001614. PubMed PMID: 31855973; PubMed Central PMCID: PMC6903359. Link

2018 international consensus meeting on musculoskeletal infection: Summary from the biofilm workgroup and consensus on biofilm related musculoskeletal infections.

Saeed K, McLaren AC, Schwarz EM, Antoci V, Arnold WV, Chen AF, Clauss M, Esteban J, Gant V, Hendershot E, Hickok N, Higuera CA, Coraça-Huber DC, Choe H, Jennings JA, Joshi M, Li WT, Noble PC, Phillips KS, Pottinger PS, Restrepo C, Rohde H, Schaer TP, Shen H, Smeltzer M, Stoodley P, Webb JCJ, Witsø E.
J Orthop Res. 2019 May;37(5):1007-1017. doi: 10.1002/jor.24229. Epub 2019 Feb 12. PubMed PMID: 30667567. Link


Genomic characterization of inpatient evolution of MRSA resistant to daptomycin, vancomycin and ceftaroline.

Wüthrich D, Cuénod A, Hinic V, Morgenstern M, Khanna N, Egli A, Kuehl R.
J Antimicrob Chemother. 2019 May 1;74(5):1452-1454. doi: 10.1093/jac/dkz003. PubMed PMID: 30726929.
Link

General Assembly, Prevention, Host Related Local: Proceedings of International Consensus on Orthopedic Infections.

Ares O, Arnold WV, Atilla B, Kumar Bari A, Battenberg A, Belzino M, Bhoite S, Clauss M, Egoavil M, Ferrand ML, Greenky M, Sarango J, Komnos G, Koo KH, Lee YK, Leibnitz M, Luis E, Naneti G, Ottolenghi J, Poojary A, Shen H, Sousa R, Thomas P, Volodymyr F, Wang Q.
J Arthroplasty. 2019 Feb;34(2S):S3-S12. doi: 10.1016/j.arth.2018.09.049. Epub 2018 Oct 21. PubMed PMID: 30352771. Link

Teaching

The team members at the Center for Musculoskeletal Infections are actively involved nationally and internationally in the field of further education and training and are very well networked in this regard.

In addition to regular lectures as part of student training at the medical faculty in Basel, the organization of continuing education courses, contributions to specialist congresses and the supervision of master's theses and dissertations, we also offer shorter or longer fellowships for interested visiting physicians.

If you are interested or have further questions, please contact zmsi@usb.ch