[Periprosthetic joint infections : Latest developments, strategies and treatment algorithms]

Orthopade. 2020 Aug;49(8):648-659. doi: 10.1007/s00132-020-03950-4.
[Article in German]

Abstract

Background: Due to their multidimensional consequences, periprosthetic joint infections are a serious complication in arthroplasty. There are disagreements in the literature regarding their classification. At the same time, a consequence for the practical procedure cannot always be derived.

Therapeutic procedures: In addition to debridement with antibiotics and implant retention, there are options for a one or two-stage change in the therapeutic procedure. Although the preservation of implants is only possible in the case of acute infections with a short duration of symptoms, prosthesis changes are indicated with a longer symptom duration. For both procedures, there are interinstitutional deviating indication criteria, weighing pros and cons. Both have specific problems, such as, in particular, the duration of the antibiotics course, the question of anchoring the prosthesis and, in the case of a two-stage procedure, the shape of the spacer.

Keywords: Antibiotics; Debridement; Endoprosthesis; Prosthesis retention; Revision surgery.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Anti-Bacterial Agents / therapeutic use*
  • Debridement*
  • Humans
  • Prostheses and Implants
  • Prosthesis Retention*
  • Prosthesis-Related Infections / therapy*
  • Reoperation*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents