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2025 International Consensus Meeting on Musculoskeletal Infection: Summary From Biofilm Workgroup on Treatment of
Jessica Amber Jennings1, Hesham Abdelbary2,3, Fatima S Abdulla2
1Department of Biomedical Engineering, University of Memphis, Memphis, Tennessee, USA.
Abstract:
Despite advancements in surgical techniques, musculoskeletal infections (MSKI) remain severe complications following orthopedic surgery, imposing a substantial financial and personal burden on patients and healthcare systems globally. To establish the current state of knowledge in this field, International Consensus Meetings (ICM) were held in 2013, 2018, and 2025, including a Biofilm Section focused on establishing state-of-the-art basic science and translational research. The latest ICM utilized a 2-year-long Delphi process that commenced on May 31, 2023, and culminated in an in-person meeting involving voting on 30 questions by 47 delegates on May 8-10, 2025, in Istanbul, Turkey. Following the voting process, the Biofilm Section formed three workgroups (Biofilm Basic Science, Biofilm Treatment, and Research Priorities) to interpret the results and disseminate the findings in Consensus Articles that highlight priorities. The following is the summation of the Biofilm Treatment Workgroup, which aims to shape future pre-clinical MSKI research directions and grant funding with respect to: (1) elevating scientific rigor to ensure reproducibility and high-quality data in preclinical research; (2) transitioning mature therapeutic concepts into rigorous in vivo models to definitively prove their clinical feasibility; and (3) accelerating the development of novel molecular targets and advanced drug-delivery systems. Finally, the workgroup acknowledged a critical shift in the funding landscape. As government support faces future challenges, there is an urgent need for increased investment from industry and philanthropic partners. Such support is essential to develop effective treatments for serious orthopedic infections and to improve outcomes for patients facing life-altering illnesses.
Insights
Musculoskeletal infections (MSKI) after orthopedic surgery require improved research. This consensus highlights needs for rigorous preclinical studies, clinical translation, and novel treatments, urging industry and philanthropic funding.
Area of Science:
- Orthopedics
- Infectious Diseases
- Biomaterials Science
Background:
- Musculoskeletal infections (MSKI) are severe orthopedic surgery complications with significant patient and healthcare burdens.
- International Consensus Meetings (ICM) have been held to address the knowledge gaps in MSKI, with a dedicated Biofilm Section.
Purpose of the Study:
- To summarize the findings of the Biofilm Treatment Workgroup from the 2025 ICM.
- To guide future preclinical research and funding for MSKI, focusing on treatment strategies.
Main Methods:
- A 2-year Delphi process culminating in an in-person meeting (May 8-10, 2025, Istanbul) with 47 delegates.
- Delegates voted on 30 questions related to MSKI biofilms.
- Formation of three workgroups (Biofilm Basic Science, Biofilm Treatment, Research Priorities) to interpret results.
Main Results:
- The Biofilm Treatment Workgroup identified key priorities for preclinical MSKI research.
- Emphasis on enhancing scientific rigor, reproducibility, and data quality in preclinical studies.
- Need to transition therapeutic concepts into validated in vivo models for clinical feasibility.
Conclusions:
- Accelerate development of novel molecular targets and advanced drug-delivery systems for MSKI.
- Acknowledge a critical shift in funding, requiring increased industry and philanthropic investment.
- Secure funding is essential for developing effective treatments and improving patient outcomes for serious orthopedic infections.
