Bone-implant interface in biofilm-associated bone and joint infections

Abstract

Total hip and knee arthroplasties are considered the procedures of the twentieth century, with dramatic improvement to the overall quality of life for millions of patients around the globe. The application of fracture fixation implants and the replacement of the arthritic joints became a common practice in modern orthopedics, relieving hundreds of thousands of patients of pain and functional disability. With a share of 38 %, orthopedics and traumatology are the worldwide leading markets of implanted biomaterials, involving millions of new patients each year as an increasing trend. Commonly used implants in orthopedics are mainly employed for the fixation or reconstruction of bones and joints or their parts and adjacent soft tissues (ligaments, tendons, menisci, etc.) and are made of biocompatible metals, polymers, ceramics, hydroxyapatite, and their combinations. The first requirement of a material's biocompatibility is that, whatever the desired function, the material should not induce any adverse effects in the patient, "just as the first principle of Hippocrates was that the doctor should do no harm". © 2014 Springer-Verlag London. All rights are reserved.