The periprosthetic infection is a permanent risk and a severe complication in joint arthroplasty. Raising numbers of cases, unsatisfactory results of treatment and high cost urge to sufficient prophylactic behaviour in primary surgery and research for new treatment strategies. In the future antibiotic coating of the implants and influence on biofilm could possibly be established. Disciplined early diagnostic measures and rational actions following the established concepts are able to create better results and reduce the extreme high costs.