The 2025 International Consensus Meeting on Musculoskeletal Infection: Research Priorities and Future Directions

Area of Science:

• Orthopedics
• Infectious Diseases
• Biomaterials

Background:

• Musculoskeletal infection (MSKI) significantly impacts orthopedic implant success and patient outcomes globally.
• International Consensus Meetings (ICM) are crucial for defining current standards and setting research agendas in MSKI.

Purpose of the Study:

• To report critical research priorities identified by the 3rd ICM to advance the prevention, diagnosis, and treatment of biofilm-associated MSKI.
• To guide future research directions based on expert consensus and delegate voting.

Main Methods:

• A 2-year Delphi process involving 1205 delegates.
• In-person voting on 102 general and 30 biofilm-specific MSKI questions.
• Establishment of a Research Priorities Workgroup to interpret results.

Main Results:

• Key priorities include enhancing diagnostics (sampling, imaging, biomarkers), developing robust in vitro/in vivo models for antibiofilm strategies.
• Further priorities involve immunological research (T-cell immunity in biofilms), clinical evaluation of novel anti-biofilm technologies, and addressing translational barriers via multi-center data.

Conclusions:

• Addressing these research priorities is essential for improving patient outcomes and reducing the burden of biofilm-associated musculoskeletal infections.
• Future research should focus on standardization, rigorous testing, immunological insights, and efficient clinical translation.