• Peter Savov, Max Ettinger, Henning Windhagen, Mohamed Omar, and Lars-Rene Tuecking.
• Orthopädische Klinik, DIAKOVERE Annastift, Medizinische Hochschule Hannover, Anna-von-Borries Str. 1-7, 30625, Hannover, Deutschland. peter.savov@diakovere.de.
• Unfallchirurg. 2022 Jan 1; 125 (1): 59-65.

AbstractWith rising numbers of revisions of total arthroplasty procedures of the lower extremities, the annual number of cases of implant-associated infection are also increasing. The conventional two-stage replacement strategy often leads to increased morbidity and mortality of patients; however, in the literature a one-stage exchange procedure shows equally good results if the indications are strictly defined. In addition to the correct diagnostics, the patient history, the inserted implant, the state of health and when applicable the pathogens present play an important role. If, among other factors, the pathogen is uncomplicated combined with a good bone and soft tissue situation and without a large number of previous operations, a single stage replacement of the endoprosthesis may be a suitable option. Despite existing controversies in the literature, this treatment approach seems to demonstrate a reduced hospitalization, reduced costs and improved patient satisfaction with the same re-revision rate. This review article explains the strategic approach to chronic infections of endoprostheses of the lower extremities based on clinical examples and a review of the current literature.© 2021. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

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