Several factors related to patient, surgical techniques and environment are attributed to periprosthetic joint infections. In this review, etiology of the periprosthetic infections and preventive measures, as well as treatment methods will be discussed.
Periprosthetic joint infections are usually caused by biofilm producing microorganisms. Evaluation of the serologic markers, cell count and the differentiation of the joint aspirate are the most reliable diagnostic tests. However definitive diagnosis is made by isolation of the microorganism from the joint. Treatment varies according to the clinical classification of the infection. Preservation of the original implants may be possible in acute hematogenous infection and in immediate postoperative period, whereas joint debridement and parenteral antibiotic treatment is an option for late chronic infections; current treatment is two stage revision where antibiotic loaded cement spacers are used in the interim period followed by a long term parenteral antibiotic administration. There is current debate regarding the dose and effective use of antibiotics impregnated within the cement spacers. In patients that two staged revision is not possible due to comorbidities, lifelong antibiotic supression and resection arthroplasty are regarded as alternative treatment options.