Background: The treatment of prosthetic joint infection (PJI) is truly challenging. Patients with infected arthroplasty face physical and psychosocial problems. Furthermore, treatment costs represent a tremendous socioeconomic burden.
Aim: This article presents an overview of the preoperative diagnosis of PJI and one- or two-stage endoprosthetic exchange options.
Method: A selective literature search was performed focusing on diagnostics and innovative surgical treatment concepts in PJI.
Results: The identification of the underlying pathogen is still the main focus in the diagnosis of PJI. State-of-the-art therapy for PJI with mature biofilm consists of implant removal with one- or two-stage exchange arthroplasty. One-stage exchange offers lower morbidity and improved functional outcome, whereas a two-stage procedure is, according to current knowledge, more favourable in terms of infection control. The novel short-term two-stage exchange regimen combines the advantages of both possibilities.
Discussion: Prosthetic joint infection represents a significant challenge for the othopaedic surgeon. Novel treatment options can help to improve outcome and lower the costs to the health care system.
Keywords: Arthroplasty; Biofilms; Biopsy; Prosthesis-related infections; Surgical revision.