Ho-ho-ho! Gather ’round, my merry friends, for I have a tale to tell—a tale not of elves and reindeer, but of the brave warriors of orthopedics battling the pesky gremlins known as musculoskeletal infections (MSKI). These infections are quite the scrooges, sneaking past our body’s defenses and causing a ruckus in the bones and joints.

Now, you might think, “Santa, surely there’s a magical potion or a cookie that could keep these infections at bay?” Well, my curious elves, the truth is, we’re still trying to map the North Pole of our immune system’s response to these invaders. There are so many questions, like how the body’s own winter wonderland—the microbiome—affects our defenses, or what role do sugar plums (I mean, nutrition) and antibiotics play in this festive fray?

To tackle this blizzard of unknowns, the Host Immunity Section of the 2023 Orthopaedic Research Society’s MSKI International Consensus Meeting (ICM) made a list, checked it twice, and came up with 78 questions that were as naughty as they were nice. They then did a deep dive, like searching for the perfect Christmas tree, into 15 of these questions, decking the halls with systematic reviews and recommendations, all while 72 ICM delegates voted on their findings.

But wait, there’s more! Twelve questions got a big “Unknown” sticker on them, like a present that can’t be opened until next Christmas. Two questions were passed along to another ICM Section, like re-gifting a fruitcake, and 45 were saved for later, as we didn’t have enough elves to tackle them all at once.

Now, on the ICM’s website, like a digital North Pole, you can find all the questions, recommendations, and the reasons behind them. Eighteen questions were as popular as a new toy on Christmas morning, with over 90% of the delegates agreeing on them. But nine recommendations were like lumps of coal, not quite making the cut.

For those questions that didn’t make the sleigh ride to consensus, there’s a bit of commentary—like a note left with milk and cookies—explaining why and how we might find answers in the future. It’s a call to action, like sending out the reindeer, to encourage specific funding and research to unwrap these mysteries.

So, my dear friends, as we await the next chapter in this saga, let’s jingle all the way to better understanding and treatment of MSKI. And remember, in the world of orthopedic research, every day is a chance to deliver gifts of knowledge and healing. Merry research to all, and to all a good fight against MSKI! 🎅🎄