gms | German Medical Science

54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

The ENDO-Concept of the One Stage Exchange Procedure for Periprosthetic Infection

Meeting Abstract

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  • corresponding author J. Wodtke - ENDO-Klinik Hamburg GmbH, Hamburg
  • L. Frommelt
  • F.-J. Löhr

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novP17

The electronic version of this article is the complete one and can be found online at:

Published: June 13, 2005

© 2005 Wodtke et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Successful treatment of periprosthetic infections is still a challenge for the surgon. Special and effective defense mechanisms of the pathogen in presence of the foreign body (FB) require an adequate concept and due diligence other than in soft tissue infection.


In 1969 BUCHOLZ developed the concept of antibiotic augmented bone cement that was effective in creating a high concentration of antibiotic directly around the FB through elution. With individual cement preparations according to the individual antibiogram the one stage exchange of the prosthesis could successfully be done. Prerequisites for this method are: an identified pathogen with susceptibility for the possible antibiotic combinations.

A complete and radical surgical debridement including bone and soft tissue and all foreign bodies (prostheseses, screws, wires, cement etc.)

The reimplantation using the individual augmented cement and postoperatively application of i.v. antibiotics for approximately 10 days

A close and permanent cooperation between surgeon an microbiologist is mandatory.


Our last evaluation (2003) of 105 consecutive one stage exchange procedures of the hip replacement showed a success rate of 87,5% (5-7 years f.u.). This is well comparable to studies of other centers and the also advocated concept of the „two stage revision".


It is a save and established method of treatment of periprosthetic infections with clear advantages for the patient, the surgeon and the economy also in comparison to the other treatment options.