Despite the improvement in surgical technique and implant design in orthopedic and trauma surgery, implant-related infections are still a challenging problem for surgeons. The use of local prophylaxis to avoid infection, such as antibiotic-loaded cement in arthroplasty, gentamicin PMMA beads and gentamicin-collagen sponge in trauma surgery, and antibacterial coating of metal implants, is discussed in the first part of this article. The second part discusses the role of local antibiotics such as gentamicin PMMA beads, and gentamicin-collagen and antibiotic-loaded cement spacers in treating implant-related infections.