Introduction: Revision surgery in periprosthetic infection often encounters defects in bone stock caused by the loosening procedures, through continuous revisions or by explantation techniques. Since bony reconstruction in the presence of infection is critical, if no antibiotic impregnated bone grafts are available, metal implants are the last resort. Lately tantalum wedges and cones have been introduced as a stable augmentation device.

Material and Methods: Since 2007 we have used 14 tantalum implants to fill bone defects in 13 cases of severe purulent periprosthetic infection (4 cones, 10 wedges). All patients are in permanent control on an outpatient basis.

Results: Primary and continuous stability was achieved in all patients and no signs of recurrent or persistent infection were found.

Conclusion: So far this concept proves to be successful and can be recommended. The stability of the implant is recorded for numerous aseptic reconstructions. Research is needed towards the surface properties of tantalum in contact with bacteria. Positive findings like in silver coating would be desirable. Further research towards impregnation possibilities of the porous structure with antibiotics for continuous elution like from cement or fleece could – in a positive result – improve septic surgery substantially.

Introduction: One stage and two stage exchange procedures are acknowledged as gold standard for revision surgery in periprosthetic infection. Since the one stage concept is ethically, medically and economically superior, the last necessary argument is a fair rate of success on a large scale. The two stage procedure could then be limited to its genuine indications only.

Material and Methods: In three years (2005/06/07) 555 one stage exchanges of the hip and the knee were carried out at our clinic. A first homogenous group of 282 cases has now been analysed and followed-up. Detailed data regarding case history, clinical situation, treatment course and complications will be presented. All cases were investigated through a telephone protocol or examination on an outpatient basis by the same person. The group contained 180 hips and 102 knees. The median age was 68, (22/91). The median follow-up time was 31 months, (51/15).

Results: The primary success rate (dismissal from hospital) was 99% (1 death, 1 disarticulation). The revised rate of success in the course of the follow-up was 92,7 %.

Conclusion: With a success rate of 92,7 % this example of the one stage performance proves the standard realisation possibility of this concept. Advantages like no impairment in the interval without prosthesis, reduced complication and risk possibilities and reduced costs speak for this procedure. Nevertheless prerequisites have to be respected. But after all the one stage procedure should be made available to all patients with the appropriate indication.