[Diagnosis and treatment of periprosthetic infections]

The differentiation of periprosthetic infections into early onset and late onset infections is the determining factor fores the therapeutic strategy. The diagnosis of chronic unapparent infections is sometimes difficult. The therapeutic success, especially in early onset infections, is essentially influenced by a well-timed diagnosis and an immediate therapy. Surgical wound debridement with preservation of the prosthesis, one-stage replacement and two-stage replacement all with concomitant appropriate systemically administered double combined antibiotics are therapeutic options depending on factors, such as the duration of the infection. Prosthesis replacement is currently the only option to treat biofilm colonization of endoprosthetic surfaces. The bacterial adhesion on polyethylene can be extremely resistant. Due to the therapeutic consequences, periprosthetic infections remain one of the worst complications in endoprosthetic joint replacement.