LONG-BJI : Integrated Strategies for the Prevention, Early Diagnosis, and Management of Long-Term Sequelae after Bone and Joint Infections

Background and Rationale
Bone and joint infections (BJIs), including periprosthetic joint infections, fracture-related infections, osteomyelitis, and spondylodiscitis, are severe conditions frequently associated with long-term sequelae despite appropriate antimicrobial and surgical management. Persistent pain, chronic inflammation, functional impairment, implant failure, relapse, and reduced quality of life represent a growing burden for patients and healthcare systems. These outcomes align with the Horizon Europe priority on post-infection long-term conditions, an area that remains underexplored in musculoskeletal infectious diseases.

Objectives
The LONG-BJI project aims to develop and validate an integrated, patient-centered approach for the prevention, early diagnosis, and long-term management of post-infectious complications in bone and joint infections. The specific objectives are to:

1. Identify clinical, microbiological, immunological, and imaging biomarkers predictive of long-term complications after BJIs.

2. Improve early and accurate diagnosis of persistent or smoldering infection using advanced microbiological and molecular tools.

3. Develop risk-stratified prevention strategies to reduce chronic infection, relapse, and functional decline.

4. Evaluate multidisciplinary management pathways to optimize long-term outcomes and quality of life in BJI survivors.

Methodology
This multicenter, multidisciplinary project will combine:

• Prospective cohort studies of patients with BJIs, with long-term follow-up.

• Advanced diagnostic approaches, including optimized microbiological techniques, molecular diagnostics, and host-response profiling.

• Digital health tools for longitudinal monitoring of symptoms, function, and treatment response.

• Clinical decision-support models integrating patient, pathogen, and treatment factors.

• Health-economic and quality-of-life analyses to assess sustainability and impact.

Expected Outcomes and Impact
LONG-BJI will:

• Enable earlier identification of patients at risk of long-term post-infectious complications.

• Reduce chronic disability, reinfection rates, and healthcare costs.

• Improve functional recovery and patient-reported outcomes.

• Provide evidence-based recommendations and care pathways adaptable across European healthcare systems.

By addressing bone and joint infections within the framework of post-infection long-term conditions, this project directly contributes to Horizon Europe Cluster Health goals, strengthening preparedness, resilience, and innovation in infectious disease management.