{"id":"https://openalex.org/W3137724692","doi":"https://doi.org/10.2106/jbjs.20.00409","title":"Providing an Evidence Base for Tissue Sampling and Culture Interpretation in Suspected Fracture-Related Infection","display_name":"Providing an Evidence Base for Tissue Sampling and Culture Interpretation in Suspected Fracture-Related Infection","publication_year":2021,"publication_date":"2021-03-25","ids":{"openalex":"https://openalex.org/W3137724692","doi":"https://doi.org/10.2106/jbjs.20.00409","mag":"3137724692","pmid":"https://pubmed.ncbi.nlm.nih.gov/33764925"},"language":"en","primary_location":{"id":"doi:10.2106/jbjs.20.00409","doi":"https://doi.org/10.2106/jbjs.20.00409","is_oa":false,"landing_page_url":"https://doi.org/10.2106/jbjs.20.00409","pdf_url":null,"source":{"id":"https://openalex.org/S128848949","display_name":"Journal of Bone and Joint Surgery","issn_l":"0021-9355","issn":["0021-9355","1058-2436","1535-1386"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-a","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310318547","host_organization_name":"Wolters Kluwer","host_organization_lineage":["https://openalex.org/P4310318547"],"host_organization_lineage_names":["Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Bone and Joint Surgery","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5050981316","display_name":"Maria Dudareva","orcid":"https://orcid.org/0000-0002-3139-7237","observed_orcids":["https://orcid.org/0000-0002-3139-7237"]},"institutions":[{"id":"https://openalex.org/I2801809904","display_name":"Nuffield Orthopaedic Centre","ror":"https://ror.org/0036ate90","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801809904","https://openalex.org/I4210147381"]},{"id":"https://openalex.org/I40120149","display_name":"University of Oxford","ror":"https://ror.org/052gg0110","country_code":"GB","type":"education","lineage":["https://openalex.org/I40120149"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"M. Dudareva","raw_affiliation_strings":["Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom"],"raw_orcid":"https://orcid.org/0000-0002-3139-7237","affiliations":[{"raw_affiliation_string":"Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom","institution_ids":["https://openalex.org/I2801809904","https://openalex.org/I40120149"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5068692938","display_name":"Lucinda K. Barrett","orcid":"https://orcid.org/0000-0002-5680-322X","observed_orcids":["https://orcid.org/0000-0002-5680-322X"]},"institutions":[{"id":"https://openalex.org/I2801809904","display_name":"Nuffield Orthopaedic Centre","ror":"https://ror.org/0036ate90","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801809904","https://openalex.org/I4210147381"]},{"id":"https://openalex.org/I40120149","display_name":"University of Oxford","ror":"https://ror.org/052gg0110","country_code":"GB","type":"education","lineage":["https://openalex.org/I40120149"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"L.K. Barrett","raw_affiliation_strings":["Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom"],"raw_orcid":"https://orcid.org/0000-0002-5680-322X","affiliations":[{"raw_affiliation_string":"Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom","institution_ids":["https://openalex.org/I2801809904","https://openalex.org/I40120149"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5072384771","display_name":"Mario Morgenstern","orcid":"https://orcid.org/0000-0001-5108-0731","observed_orcids":["https://orcid.org/0000-0001-5108-0731"]},"institutions":[{"id":"https://openalex.org/I2802542264","display_name":"University Hospital of Basel","ror":"https://ror.org/04k51q396","country_code":"CH","type":"healthcare","lineage":["https://openalex.org/I2802542264"]}],"countries":["CH"],"is_corresponding":false,"raw_author_name":"M. Morgenstern","raw_affiliation_strings":["Center for Musculoskeletal Infections, Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland"],"raw_orcid":"https://orcid.org/0000-0001-5108-0731","affiliations":[{"raw_affiliation_string":"Center for Musculoskeletal Infections, Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland","institution_ids":["https://openalex.org/I2802542264"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5080811032","display_name":"Bridget L. Atkins","orcid":"https://orcid.org/0000-0001-8778-0633","observed_orcids":["https://orcid.org/0000-0001-8778-0633"]},"institutions":[{"id":"https://openalex.org/I2801809904","display_name":"Nuffield Orthopaedic Centre","ror":"https://ror.org/0036ate90","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801809904","https://openalex.org/I4210147381"]},{"id":"https://openalex.org/I40120149","display_name":"University of Oxford","ror":"https://ror.org/052gg0110","country_code":"GB","type":"education","lineage":["https://openalex.org/I40120149"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"B.L. Atkins","raw_affiliation_strings":["Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom"],"raw_orcid":"https://orcid.org/0000-0001-8778-0633","affiliations":[{"raw_affiliation_string":"Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom","institution_ids":["https://openalex.org/I2801809904","https://openalex.org/I40120149"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5017409051","display_name":"Andrew Brent","orcid":"https://orcid.org/0000-0002-5349-0723","observed_orcids":["https://orcid.org/0000-0002-5349-0723"]},"institutions":[{"id":"https://openalex.org/I2801809904","display_name":"Nuffield Orthopaedic Centre","ror":"https://ror.org/0036ate90","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801809904","https://openalex.org/I4210147381"]},{"id":"https://openalex.org/I40120149","display_name":"University of Oxford","ror":"https://ror.org/052gg0110","country_code":"GB","type":"education","lineage":["https://openalex.org/I40120149"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"A.J. Brent","raw_affiliation_strings":["Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom"],"raw_orcid":"https://orcid.org/0000-0002-5349-0723","affiliations":[{"raw_affiliation_string":"Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom","institution_ids":["https://openalex.org/I2801809904","https://openalex.org/I40120149"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5085215589","display_name":"Martin McNally","orcid":"https://orcid.org/0000-0003-2003-9044","observed_orcids":["https://orcid.org/0000-0003-2003-9044"]},"institutions":[{"id":"https://openalex.org/I2801809904","display_name":"Nuffield Orthopaedic Centre","ror":"https://ror.org/0036ate90","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801809904","https://openalex.org/I4210147381"]},{"id":"https://openalex.org/I40120149","display_name":"University of Oxford","ror":"https://ror.org/052gg0110","country_code":"GB","type":"education","lineage":["https://openalex.org/I40120149"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"M.A. McNally","raw_affiliation_strings":["Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom"],"raw_orcid":"https://orcid.org/0000-0003-2003-9044","affiliations":[{"raw_affiliation_string":"Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom","institution_ids":["https://openalex.org/I2801809904","https://openalex.org/I40120149"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":11.7919,"has_fulltext":false,"cited_by_count":81,"citation_normalized_percentile":{"value":0.99331645,"is_in_top_1_percent":true,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":87,"max":100},"biblio":{"volume":"103","issue":"11","first_page":"977","last_page":"983"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11293","display_name":"Orthopedic Infections and Treatments","score":0.9965999722480774,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11293","display_name":"Orthopedic Infections and Treatments","score":0.9965999722480774,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10658","display_name":"Bone fractures and treatments","score":0.0020000000949949026,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11381","display_name":"Infectious Diseases and Tuberculosis","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/fracture-related-infection","display_name":"fracture-related infection","score":0.9980000257492065},{"id":"https://openalex.org/keywords/microbiological-analysis","display_name":"microbiological analysis","score":0.7020000219345093},{"id":"https://openalex.org/keywords/diagnostic-accuracy","display_name":"diagnostic accuracy","score":0.5130000114440918},{"id":"https://openalex.org/keywords/sensitivity-and-specificity","display_name":"sensitivity and specificity","score":0.7480000257492065}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6923521757125854},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.4935115575790405},{"id":"https://openalex.org/C82157600","wikidata":"https://www.wikidata.org/wiki/Q2671652","display_name":"Diagnostic test","level":2,"score":0.44732803106307983},{"id":"https://openalex.org/C3020132585","wikidata":"https://www.wikidata.org/wiki/Q2671652","display_name":"Diagnostic accuracy","level":2,"score":0.44596779346466064},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3874461054801941},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.3412977457046509},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.2980957329273224},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.2573060691356659},{"id":"https://openalex.org/C42972112","wikidata":"https://www.wikidata.org/wiki/Q170201","display_name":"Veterinary medicine","level":1,"score":0.1297883689403534}],"mesh":[{"descriptor_ui":"D000293","descriptor_name":"Adolescent","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000369","descriptor_name":"Aged, 80 and over","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005592","descriptor_name":"Fracture Fixation","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012680","descriptor_name":"Sensitivity and Specificity","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013530","descriptor_name":"Surgical Wound Infection","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":false},{"descriptor_ui":"D013530","descriptor_name":"Surgical Wound Infection","qualifier_ui":"Q000382","qualifier_name":"microbiology","is_major_topic":true},{"descriptor_ui":"D019317","descriptor_name":"Evidence-Based Medicine","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D032921","descriptor_name":"Consensus","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D050723","descriptor_name":"Fractures, Bone","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true},{"descriptor_ui":"D055815","descriptor_name":"Young Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.2106/jbjs.20.00409","doi":"https://doi.org/10.2106/jbjs.20.00409","is_oa":false,"landing_page_url":"https://doi.org/10.2106/jbjs.20.00409","pdf_url":null,"source":{"id":"https://openalex.org/S128848949","display_name":"Journal of Bone and Joint Surgery","issn_l":"0021-9355","issn":["0021-9355","1058-2436","1535-1386"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-a","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310318547","host_organization_name":"Wolters Kluwer","host_organization_lineage":["https://openalex.org/P4310318547"],"host_organization_lineage_names":["Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Bone and Joint Surgery","raw_type":"journal-article"},{"id":"pmid:33764925","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/33764925","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The Journal of bone and joint surgery. American volume","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.9537000060081482,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[{"id":"https://openalex.org/G5065961320","display_name":"Predicting Risk In Management of Infection in Orthopaedics (PRIMIO): developing risk-prediction model and a pre-operative strategy based on risk factors, to reduce recurrence of orthopaedic infection after treatment","funder_award_id":"NIHR300249","funder_id":"https://openalex.org/F4320319990","funder_display_name":"National Institute for Health and Care Research"}],"funders":[{"id":"https://openalex.org/F4320319990","display_name":"National Institute for Health and Care Research","ror":"https://ror.org/0187kwz08"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":21,"referenced_works":["https://openalex.org/W1619311789","https://openalex.org/W1967385290","https://openalex.org/W1981860512","https://openalex.org/W1995945562","https://openalex.org/W2053899483","https://openalex.org/W2054075895","https://openalex.org/W2107766836","https://openalex.org/W2141813163","https://openalex.org/W2154366164","https://openalex.org/W2155697196","https://openalex.org/W2187204747","https://openalex.org/W2590127803","https://openalex.org/W2747036772","https://openalex.org/W2794698021","https://openalex.org/W2797940224","https://openalex.org/W2803955250","https://openalex.org/W2809166698","https://openalex.org/W2892373884","https://openalex.org/W2937870634","https://openalex.org/W2961603915","https://openalex.org/W2969300673"],"related_works":["https://openalex.org/W3164928569","https://openalex.org/W4413804133","https://openalex.org/W4366686326","https://openalex.org/W3210406596","https://openalex.org/W4220945958","https://openalex.org/W2906808394","https://openalex.org/W7161631685","https://openalex.org/W2937870634","https://openalex.org/W3118741063","https://openalex.org/W3046749082"],"abstract_inverted_index":{"BACKGROUND:":[0],"The":[1,161,251],"recent":[2],"consensus":[3],"definition":[4],"for":[5,48,69,80,107,145,155,207,261,272,296,298],"the":[6,13,33,59,124,138,146,156,208,255,262,267],"diagnosis":[7,209,263],"of":[8,15,36,61,64,72,86,100,126,142,148,159,163,176,180,210,214,264,275,302,304],"fracture-related":[9],"infection":[10],"(FRI)":[11],"includes":[12],"identification":[14],"indistinguishable":[16,152,184],"microorganisms":[17,153,168,185,242],"in":[18,75,90,116,243,247,281],"at":[19,177,244,276],"least":[20,178,245,277],"2":[21,101,179],"surgical":[22,78,88,102,149],"deep-tissue":[23,73,103,236,279],"specimens":[24,37,65,74,104,113,150,182,216,237,280],"as":[25],"a":[26,39,299],"confirmatory":[27,128,269],"criterion.":[28],"However,":[29],"this":[30],"cut-off,":[31],"and":[32,66,140,154,199,225],"total":[34,85,157],"number":[35,147,158],"from":[38],"patient":[40],"with":[41,93,183,283],"suspected":[42,94],"FRI":[43,95,120,285],"that":[44],"should":[45],"be":[46],"sent":[47],"microbiological":[49,70,108,259],"testing,":[50],"have":[51],"not":[52],"been":[53],"validated.":[54],"We":[55],"endeavored":[56],"to":[57,136,197,205,223,231,257],"estimate":[58],"accuracy":[60],"different":[62],"numbers":[63],"diagnostic":[67,143,174,270],"cut-offs":[68,144],"testing":[71],"patients":[76,92,282],"undergoing":[77],"treatment":[79],"possible":[81,284],"FRI.":[82,211,273],"METHODS:":[83],"A":[84,98,173],"513":[87],"procedures":[89,118],"385":[91],"were":[96,105,114,217],"included.":[97],"minimum":[99],"submitted":[106],"testing;":[109],"5":[110,181,278],"or":[111],"more":[112],"analyzed":[115],"345":[117],"(67%).":[119],"was":[121,134,169,189,254],"defined":[122],"by":[123,187],"presence":[125],"any":[127],"criteria":[129,260,271],"other":[130],"than":[131],"microbiology.":[132],"Resampling":[133],"utilized":[135],"model":[137],"sensitivity":[139],"specificity":[141],"yielding":[151],"specimens.":[160],"likelihood":[162],"detecting":[164],"all":[165],"clinically":[166,240],"relevant":[167,241],"also":[170],"assessed.":[171],"RESULTS:":[172],"cut-off":[175],"identified":[186],"culture":[188],"68%":[190],"sensitive":[191,219],"(95%":[192,202,220,228],"confidence":[193],"interval":[194],"[CI],":[195],"62%":[196],"74%)":[198],"87%":[200],"specific":[201,227],"CI,":[203,221,229],"81%":[204],"94%)":[206],"Two":[212],"out":[213],"3":[215,235],"60%":[218],"55%":[222],"66%)":[224],"92%":[226],"88%":[230],"96%).":[232],"Submitting":[233],"only":[234],"risked":[238],"missing":[239],"1":[246],"10":[248],"cases.":[249],"CONCLUSIONS:":[250],"present":[252],"study":[253],"first":[256],"validate":[258],"FRI,":[265],"supporting":[266],"current":[268],"Analysis":[274],"is":[286],"recommended.":[287],"LEVEL":[288],"OF":[289],"EVIDENCE:":[290],"Diagnostic":[291],"Level":[292],"III.":[293],"See":[294],"Instructions":[295],"Authors":[297],"complete":[300],"description":[301],"levels":[303],"evidence.":[305]},"counts_by_year":[{"year":2026,"cited_by_count":11},{"year":2025,"cited_by_count":15},{"year":2024,"cited_by_count":23},{"year":2023,"cited_by_count":16},{"year":2022,"cited_by_count":12},{"year":2021,"cited_by_count":1},{"year":2020,"cited_by_count":1},{"year":2019,"cited_by_count":1}],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2021-03-29T00:00:00"}