Infect Dis Clin N Am 19 (2005) xiiixiv

Preface

Update on Musculoskeletal Infections

John J. Ross, MD
Guest Editor

Musculoskeletal infections are perhaps orphan conditions poised at the

boundary between three disciplines: infectious diseases, orthopedic surgery,
and rheumatology. However, these forlorn infections are likely to grow in
importance and prevalence in North America as the population ages and
the burden of risk factors such as underlying arthritis, diabetes mellitus,
and immunosuppression increases. To complicate matters, drug-resistant
bacteria such as methicillin-resistant Staphylococcus aureus are playing
a greater role as pathogens in musculoskeletal infections. Outcomes are often poor. Osteomyelitis, especially in diabetic patients, can literally threaten
life and limb. Septic arthritis of both prosthetic and native joints can permanently hamper mobility and locomotion. The limited ability of musculoskeletal tissue to regenerate may make these infections permanently disabling.
This issue of the Infectious Disease Clinics of North America attempts to
dene the state-of-the-art approach to such infections, including the problems and pitfalls associated with the management of mycobacterial, fungal,
and borrelial musculoskeletal infection; the controversies associated with reactive arthritis; and the role of antibiotic prophylaxis in orthopedic surgery,
as well as the management of open fractures. Finally, we explore the promise of the emerging technologies loosely lumped together under the category
of gene therapy.
I wish to thank the contributors to this issue for lending their time, eort,
and expertise. I realize my great fortune in working with such a talented,
knowledgeable, and diverse group of rheumatologists, orthopedic surgeons,
and infectious disease specialists. I also wish to express my gratitude to my
family; to Carin Davis, Elseviers editor extraordinaire, for her patience and
0891-5520/05/$ - see front matter 2005 Elsevier Inc. All rights reserved.
doi:10.1016/j.idc.2005.09.001

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xiv

PREFACE

diligence; and to Dr. Robert Moellering for the opportunity to edit this issue. Lastly, I wish to acknowledge my indebtedness to a trio of extraordinary physicians who rst sparked my interest in infectious diseases:
Michael G. Worthington, Jerey K. Griths, and Sherwood L. Gorbach.
John J. Ross, MD
Division of Infectious Diseases
Caritas St. Elizabeths Medical Center
736 Cambridge Street
Boston, MA 02135, USA
E-mail address: jrossmd@cchcs.org