Orthopaedic implant infections: current management strategies

Orthopaedic joint replacement and spinal stabilisation surgery has provided pain relief and functional improvement for millions. Postoperative infections involving the implanted hardware can have devastating functional, emotional and financial consequences. Implementation of relevant preoperative patient preparation, utilisation of appropriate prophylactic antimicrobials and intraoperative infection control measures have combined to diminish orthopaedic implant infection frequency significantly. Our adeptness at establishing the presence of an implant-related infection with certainty is not as well advanced. Similarly, treatment guidelines, while useful, remain somewhat anecdotal. The pathogenesis, risk factors, diagnosis, management and prevention of hip arthroplasty infection and spinal stabilisation with instrumentation infection are reviewed.