Etiopathogenesis: 1 million prostheses, including knee and hip prosthesis, are made annually all over the world and periprosthetic infection occurs in approximately 1% of these surgeries. The number of infected prostheses is increasing every year, and it is predicted to become a serious health problem in the next 10 years. For this reason, as in the whole world, in our country, first of all, prevention measures are taken against prosthesis infection and the treatment of infected prostheses is also important.

Clinical: The diagnosis of infected prosthesis is made by clinical, laboratory tests and joint aspiration. Patients diagnosed in the first 3-6 weeks are called acute periprosthetic infection, and those diagnosed after the 6th week are called late infection. In acute infections, while the patient comes with pain, redness and swelling in the knee; In late infection, the patient comes with a runny wound extension associated with the joint called discharge or fistula. In both cases, the patient comes with pain, inability to walk, and limitation in daily activities.

Diagnosis: In both acute and chronic prosthetic infections, CRP, Sedimentation and Leukocyte are significantly increased and are helpful in diagnosis. However, the definitive diagnosis is made by demonstrating the presence of microorganisms in the joint by performing joint aspiration. Usually produced microbe Staf. Aureus. In addition, Leukocyte esterase test and ∝-Defensin tests help confirm the diagnosis between 90-95%.

Treatment: Early treatment increases the chance of success in acute prosthetic infections. After opening the joint, removing all infected tissues, washing with plenty of serum and replacing the insert, 3-6 weeks of antibiotic treatment given in accordance with the microorganism is successful between 90-100%. In chronic infections; Two-stage treatment should be done. In the first stage, the joint should be thoroughly cleaned by removing all the prosthetic material, removing all infected tissues with debridement and washing with plenty of serum. After that, the antibiotic is mixed and a temporary prosthesis called spacer is placed. These temporary prostheses can be mobile and fixed. It is decided which one will be preferred according to the condition of the patient and the bones and ligaments in the joint. After this surgery, antibiotic treatment is given for 3-6 weeks, depending on the microbe found. If CRP, Sedimentation and Leukocyte values ​​return to normal or near normal values ​​after 6 weeks of antibiotic treatment and 2 weeks of waiting, joint puncture is performed. If germs do not grow in joint aspiration performed twice consecutively, the second stage can be passed. However, it is recommended not to pass this stage before 3 months in terms of the general health status of the patient. In the second stage surgery, the spacer is removed and the joint is cleaned again. In the meantime, the absence of microbes in the joint histological examination (frozen) helps to decide on a new prosthesis. If any microbes are seen in this examination, the first stage procedures are repeated. If it is decided that the joint is clean in the second stage, prostheses called revision prosthesis, which allow the reconstruction of both bone and ligaments, should be used. After this surgery, the patient should be closely followed up for 3-6 months in terms of recurrence of the infection.