Implant Infections

Implant infections are notoriously difficult to treat. They’re caused by biofilm—densely packed colonies of bacteria with increased resistance to antibiotics due to changes in gene regulation, molecular transport, and cell activity. Prior to the last two decades, improvements in surgical technique decreased the incidence of implant infections to 1-2%. However, a growing concern due to rising infection rates and increasing procedure volumes belies previous improvements. Studies show a rising incidence over the prior decade. According to the 2024 annual report from the American Joint Replacement Registry (AJRR), infection is the leading cause of knee revision surgery, responsible for 33.1% of all total knee revisions between 2012 and 2023. Similarly, infection is the most common reason for total hip revision surgery, accounting for 21.4% of all hip revisions during the same period. This correlates with rising rates of comorbidities like obesity and diabetes. Additionally, current age trends indicate a rise in the absolute number of procedures.