Department of Orthopædics & Rehabilitation, Yale University, School of Medicine, New Haven, CT, USA; Yale University School of Medicine, Department of Orthopaedics and Rehabilitation, 330 Cedar St, TMP 523, PO Box 208071, New Haven, CT 06520-8071, USA.
Department of Orthopædics & Rehabilitation, Yale University, School of Medicine, New Haven, CT, USA; Department of Life Science, Chung-Ang University, Seoul, Republic of Korea; Yale University School of Medicine, Department of Orthopaedics and Rehabilitation, 330 Cedar St, TMP 523, PO Box 208071, New Haven, CT 06520-8071, USA.
Bone. 2020 Dec;141:115568. doi: 10.1016/j.bone.2020.115568. Epub 2020 Jul 31.
Bone and joint infections are devastating afflictions. Although medical interventions and advents have improved their care, bone and joint infections still portend dismal outcomes. Indeed, bone and joint infections are associated with extremely high mortality and morbidity rates and, generally, occur secondary to the aggressive pathogen Staphylococcus aureus. The consequences of bone and joint infections are further compounded by the fact that although they are aggressively treated, they frequently recur and result in massive bone and articular cartilage loss. Here, we review the literature and chronicle the fact that the fundamental cellular components of the musculoskeletal system can be internally infected with Staphylococcus aureus, which explains the ready recurrence of bone and joint infections even after extensive administration of antibiotic therapy and debridement and offer potential treatment solutions for further study. Moreover, we review the ramifications of intracellular infection and expound that the massive bone and articular cartilage loss is caused by the sustained proinflammatory state induced by infection and offer potential combination therapies for further study to protect bone and cartilage.
骨与关节感染是毁灭性的疾病。尽管医疗干预和进展改善了它们的治疗效果,但骨与关节感染仍然预示着预后不良。事实上,骨与关节感染与极高的死亡率和发病率相关,通常继发于侵袭性病原体金黄色葡萄球菌。骨与关节感染的后果进一步加重,因为尽管它们被积极治疗,但它们经常复发,导致大量骨和关节软骨丧失。在这里,我们回顾了文献,并记录了一个事实,即骨骼肌肉系统的基本细胞成分可以被金黄色葡萄球菌内部感染,这解释了为什么即使在广泛使用抗生素治疗和清创术之后,骨与关节感染仍然容易复发,并为进一步研究提供了潜在的治疗解决方案。此外,我们回顾了细胞内感染的后果,并阐述了大量骨和关节软骨的丧失是由感染引起的持续的促炎状态引起的,并为进一步研究提供了潜在的联合治疗方案,以保护骨骼和软骨。