Infections of hip prostheses and artificial joints.

Infections following total joint arthroplasty have been dramatically lowered with the administration of prophylactic antibiotics. Anecdotal experience as well as prospective data suggests that ultra-clean operating rooms can further reduce the incidence of postoperative wound sepsis following total joint arthroplasty. Once a deep infection complicates a total joint arthroplasty, resection arthroplasty will usually be necessary. Staphylococci are the most common causal organisms. Four weeks of specific, parenteral therapy should be administered at the time of the resection arthroplasty. Reconstruction with another total joint can be performed in a "one-staged" or a delayed fashion. The decision as to which procedure should be performed is made based on the degree of virulence of the infection (microbiology) and the anatomic location. Successful reconstruction can be achieved in 95 per cent of carefully selected patients.