Abstract
Microorganisms adhere to foreign bodies and form a biofilm, that protects against natural defence mechanisms and antibiotics. Because of these properties, surgery is required to cure an infected implant.
The type of surgery is different in early, delayed and late hematogenous infections.
Thorough debridement, with retention of the prosthesis but with exchange of the mobile parts, is possible in cases of early infections and in late hematogenous infections, if the implant is stable and the soft tissues intact.
If these conditions are not met and in delayed infections, the implant will have to be removed and a new prosthesis implanted.
This can be done in a one stage or in a two stage procedures; in most centres, one or the other procedure is favoured for all cases.
However, depending of the condition of the soft tissues, the presence or absence of concommittant diseases and the type of microorganism responsible for the infection, a decision toward either a one stage or a two stage procedure can be made.
Salvage procedures like a permanent resection, an arthrodesis or an amputation are less satisfactory for the patient.
