Musculoskeletal infections, including infected non-unions, osteomyelitis and periprosthetic joint infections, are one of the biggest healthcare challenges of the 21st century.

As the rapid growth of antibiotic-resistant strains and biofilms continues to outpace the development of new antibiotics and antibiotic strategies, care delivery is becoming increasingly challenging and complicated.

Bone and joint trauma, such as fractures and dislocations, are common and vary in severity from single fractures to multiple, life-threatening musculoskeletal injuries.

The most clinically challenging of these for the surgeon, and those that have the most socioeconomic burden, are open fractures. These often involve damage to the surrounding soft tissue, resulting in complications such as tissue and deep bone infection or long-term non-union.

The popularity of spine surgery differs around the world. The number of procedures performed in the USA is double the number performed in Western Europe, Canada and Australia combined, and five times the number in the UK.

In the USA, the number of spinal fusion procedures increased by 64% between 2002 and 2014, from approximately 268,000 to 414,000. The average cost per procedure has increased from $15,868 to $28,954 over the same period and was more than $12 billion in total in 2014.