Incidence and socioeconomic impact of bone and joint infections (BJIs): The European perspective

Epidemiologic studies demonstrate that population fragmented ageing and increased urbanisation, and motorisation across the globe increase the prevalence of trauma and age-related musculoskeletal conditions, such as fragility fractures and arthritis. The number of primary and revision arthroplasties has increased steadily in the last 20 years and so does the number of fractures treated with implantation of hardware. These numbers are anticipated to further escalate over the next two decades. The prevalence of deep infection following joint replacements and the number of posttraumatic infections is projected to increase at a faster rate as a result of a tendency to operate more on high-risk patients, at greater ages, with diabetes, other comorbidities and immunosuppression. This is further increasing the severity of septic complications and other adverse outcomes, which can often lead to functional impairment, long-lasting disability, or even permanent handicap with an inevitable social and economic burden. Musculoskeletal infections place an additional cost burden on total healthcare expenditures, which are already rising faster than the gross domestic product in most countries, and may also become life-threatening conditions. The scientific community needs to take a more active role to increase awareness and in collaboration with policy makers and funding organisations, collect valid data, construct an action plan and put the scourge of the bone and joint infections higher in the agenda of health care priorities.