R ESEARCH C AVEATS

RECOMMENDATION: It remains unclear whether the native joint or a joint after arthroplasty can be considered a microbiological niche in which specific organisms reside without causing any manifestation of infection. However, given the innocuous character of microorganisms (such as coagulase-negative Staphylococcus, Cutibacterium species) recovered from clinical specimens in the context of aseptic loosening it appears plausible to hypothesize that chronic colonization of devices can occur and be of long-lasting nature before signs and symptoms of clinical infection occur, if they occur at all. Further studies are needed to determine the clinical relevance of microorganisms or microbial dysbiosis detected within joints, without apparent clinical features of infection, ensuring clinical correlation, long-term followup and multicenter validation.