concern that there might be a joint infection in the prosthesis.

 8. Brause BD. Infections associated with prosthetic joints.  1986;12:523-36

Infected prosthetic knees cause problems -- ScienceDaily

Local and systemic host factors that may affect treatment and prognosis of periprosthetic joint infections according ot Cierny and DiPasquale [].

24. Esposito S, Leone S. Prosthetic joint infections: microbiology, diagnosis, management and prevention.  2008;32:287-93

The Center for Prostheses Infection was established in April 1999

15. Atkins BL, Athanasou N, Deeks JJ, Crook DW, Simpson H, Peto TE, McLardy-Smith P, Berendt AR. Prospective evaluation of criteria for microbiological diagnosis of prosthetic-joint infection at revision arthroplasty. The OSIRIS Collaborative Study Group. 1998;36:2932-9

16. Schäfer P, Fink B, Sandow D, Margull A, Berger I, Frommelt L. Prolonged bacterial culture to identify late periprosthetic joint infection: a promising strategy. 2008;47:1403-9

Painful Infection at the Site of Hip Prosthesis: CT Imaging

Tsukayama et al. proposed a 4-stage system consisting of early postoperative-, late chronic-, and acute hematogenous infections, and positive intraoperative cultures of specimens obtained during revision of a presumed aseptically loose total hip prosthesis [].

[Infection of a hip prosthesis after dry needling]. - IDN

Based on the afore mentioned data, McPherson et al. developed a staging system for periprosthetic hip infections taking into consideration the acuteness of the infection, the overall medical and immune health status of the patient, and the local wound condition (Table ) []. The classification of each infection may assist the surgeon identify the severity of each infection case and choose an appropriate treatment option. The system has been used in clinical practise especially in the United States and the United Kingdom [, ].

Cases reported " Prosthesis-Related Infections

Cierny and DiPasquale tried to adjust the Cierny classification system for osteomyelitis in adult patients [] also for the classification of periprosthetic total joint infections []. In this system, prosthetic joint infections are entered as anatomic types of the disease: early and superificial osteomyelitis (Type II) or late and refractory osteomyelitis (Type IV of the initial osteomyelitis staging system). Besides this anatomic differentiation, the authors added local and systemic host factors that may affect treatment and prognosis. In this system, patients are categorized as A-, B-, or C-hosts. A-hosts are healthy and without healing deficiencies. B-hosts are compromised by one or more local and/or systemic parameters (Table ). C-hosts are patients for whom the morbidity of cure far exceeds that of their illness or surpasses their capacity to withstand curative treatment. C-hosts are not considered candidates for aggressive surgical intervention but rather for conservative treatment.

Cases reported • Prosthesis-Related Infections

Resources on Infected total knee replacement and related.2015/16 ICD-10-CM T85.79XA Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, initial encounter.

Repeated bacterial infection after knee prosthesis, ..

The therapeutic approach has to be selected in accordance with the mode of infection (NJI, PJI, RA), the expected or found pathogens, and their resistance. It should be remembered that the slowed growth of bacteria in a biofilm on surfaces of joint prosthesis may additionally reinforces antibiotic resistance [,]. Responsible for such an increase against antibacterial substances are changes in cell wall synthesis, which limits the effect of beta-lactam antibiotics and glycopeptides, and the occurrence of bacterial variants with modifications of other metabolic activities, with implications for the action of quinolones, aminoglycosides, and tetracyclines. In principle, the spectrum of available antibiotics is limited by the specific pharmacokinetic requirements in the treatment of joint infections. This applies particularly to chronic infections and prosthesis infections. For an overview of common substances and therapeutic regimes, see Table .