| Pathogenesis |
|
|
| - Perioperative origin |
Early postoperative |
Delayed postoperative (low-grade) |
| <4 weeks after surgery |
≥4 weeks after surgery |
| - Hematogenous origin |
<3 weeks of symptoms |
≥3 weeks of symptoms |
| Biofilm age (maturity) |
Immature |
Mature |
| Clinical features |
Acute joint pain, fever, red/swollen joint |
Chronic pain, loosening of the prosthesis, sinus tract (fistula) |
| Causative microorganism |
High-virulent: Staphylococcus aureus, gram-negative bacteria (e.g. Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa) |
Low-virulent: Coagulase-negative staphylococci (e.g. Staphylococcus epidermidis), Propionibacterium acnes
|
| Surgical treatment |
Débridement & retention of prosthesis (change of mobile parts) |
Complete removal of prosthesis (exchange in one-, two-, or multiple stages) |
