Prosthetic joint infections: controversies and clues

Joint replacement is one of the marvels of modern medicine. It has enabled about half a million people each year to regain physical function and to become free of pain.

Infection associated with the prosthesis is a dreaded complication. The intensive interest in the epidemiology, prevention, and management of the infectious disease process,

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coupled with the, fortunately, low rates of infection, have yielded many published case-series that suffer from surveillance and reporting bias, confounding, and weak statistical power. The point has resulted in controversy associated with every aspect of prosthetic-joint infections, including identification of host risk factors, prevention, diagnosis, and treatment. Interest in prosthetic-joint infections has also spawned research into the distinct properties of adherent bacteria and has led to new strategies in antibiotic therapy.

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