The deep chronic infection of arthroplasty implants is a serious problem and requires great effort and cost for its treatment. Pharmacological and surgical options of treatment have been reported in the literature. The issues related to this situation are the route of administration and duration of antibiotics, stages of surgery, and the time of re-implantation of the new prosthesis. There are different protocols of antibiotics regimens which range from no antibiotics to a long course of parenteral antibiotic for 9 weeks, followed by oral administration. The costing, and side effects or toxicity of the antibiotic are the causes of these controversies. The surgical solutions also vary from resection arthroplasty (Girdlestone), retention of the prosthesis with debridement, onestage revision, and two-stage revision with hand-made cement spacer loaded with antibiotic, or with prefabricated spacer prosthesis.
Sayed El-Etewy Soudy and Mohsen Fawzy Omar