Abstract

Due to the widespread use of prosthetic orthopedic devices, we more often come across with related complications. Although, surgical infection rates have decreased due to the infection control measures, prosthetic infections still cause distress for both patients and physicians. In this review article the incidence of orthopedic implant infections, troublesome diagnostic processes and treatment approaches are discussed in detail. Biofilm layer on the prosthesis, which facilitates adhesion of the microorganisms to a foreign body part, thereby leading to treatment failure, plays an important role in pathogenesis. Lack of a gold standard for diagnosis necessitates the combined use of clinical features, imaging and other laboratory techniques. Most appropriate treatment approach should be determined according to characteristics of the patient. Treatment approaches are debridement and retention of the prosthesis and/or lifelong suppressive antibiotic therapy, single or two-stage revision, or removal of the implant, arthrodesis or amputation in very desperate cases. Antibiotic agents of choice for treatment and duration of treatment are other important issues that should be considered in the treatment.