Mechanisms of Bacterial Resistance in Implant Infection

Although prophylaxis has cut down the infection rate in any type of implant to an average of 2.3% (0.38%-10%), the increased number of orthopaedic implants worldwide results in an extremely high number of cases yearly. Infection is also one of the most serious complications of implant surgery: it provokes life-long clinical sequelae, and greatly increases the difficulty and cost of treatment.

Most bacterial infections respond to antibiotics alone, but implant infections do not. Most of the hypotheses developed over the last 40 years have been confirmed in clinical practice, and the most recent ones have not replaced earlier ones (Tab. I).