Joseph Johnson, M.D., associate professor in the Department of Orthopaedic Surgery at the University of Alabama at Birmingham (UAB), has been awarded a Pilot and Feasibility Study grant from the UAB Comprehensive Arthritis, Musculoskeletal, Bone and Autoimmunity Center (CAMBAC). His study, titled “Immunologic Phenotyping of Fracture-Related Infection Patients at Risk for Treatment Failure,” seeks to improve clinical outcomes for patients with fracture-related infections (FRIs) through early immunologic intervention.
The interdisciplinary project will examine immune response patterns known as immunologic phenotypes in patients undergoing treatment for FRIs, with the goal of identifying biomarkers that may indicate treatment success or failure earlier in the clinical course. The work reflects CAMBAC’s mission to support collaborative, translational research aimed at improving musculoskeletal care.
“This is a devastating complication following fracture fixation,” Johnson said. “FRI is a significantly understudied area. Only since 2018 has the medical community adopted a consensus definition, and because complications aren't often publicly discussed, there remains a lack of high-quality data to guide treatment.”
FRIs present unique treatment challenges, including the absence of reliable clinical tools to track progress.
“Currently, our only methods of monitoring are visual assessment of wounds or reading imaging,” said Johnson. “If we had a way to track immune response in real time, we could intervene sooner, shorten treatment courses, and reduce the overall impact on patients.”
Key research goals include establishing methods to measure immune markers in FRI patients and determining how those markers correlate with clinical outcomes. “Our primary challenge is the lack of mechanisms to monitor response to treatment,” Johnson added. “Addressing this gap could meaningfully shift how we manage these complex cases.”
CAMBAC will provide up to $125,000 in funding over two years, with further support contingent on progress and regulatory approval. The initiative is co-sponsored by CAMBAC, the Department of Orthopaedic Surgery, the Division of Infectious Diseases, and the Heersink School of Medicine Immunology Institute.
For Johnson, the award is both professionally validating and personally meaningful. “This is an early step toward improving care for a population we see frequently at UAB as a high-volume referral center. It’s a rare opportunity to produce data that could guide global practice and lay the foundation for future research, treatment protocols, and best practices in a field that urgently needs them.”
“This project represents exactly what CAMBAC was designed to foster, collaborative science that bridges disciplines and may lead to tangible improvements in patient care,” said Kenneth Saag, M.D., M.Sc., director of CAMBAC. “We are proud to support Dr. Johnson’s effort to develop new tools that could ultimately transform the management of fracture-related infections.”
The significance of this research extends beyond the immediate project, highlighting the broader impact of innovative approaches in musculoskeletal medicine. Leaders within the department recognize the potential for this study to reshape clinical practices in meaningful ways.
“Dr. Johnson’s work exemplifies the kind of innovative, translational research we aim to support in the Department of Orthopaedic Surgery,” said Steven M. Theiss, M.D., chair of the Department of Orthopaedic Surgery. “Fracture-related infections are one of the most challenging complications we face, and this study has the potential to change the way we monitor and treat them at a fundamental level.”