Deep infection in total hip arthroplasty

Description: Objective: To report on a 30-year prospective study of deep infection in 1993 consecutive total hip arthroplasties performed by a single surgeon.
Conclusion: From 2–20 years, the incidence of deep infection doubled. Preoperative recognition of the first 4 risk factors permits the use of additional prophylactic measures. Spinal or epidural anesthesia reduced the units of blood transfused (the fifth risk factor) and, hence, the risk of in- fection. Although most deep infections are seeded while the wound is open, there are many possible postoperative causes. In this study, fewer than one-third of the infections that presented after 2 years were related to hematogenous spread. The efficacy of clean air technology was supported, and it is rec- ommended that all measures that may reduce the incidence of deep infection be employed.
Henry Hamilton, MD; John Jamieson, PhD Can J Surg, Vol. 51, No. 2, April 2008 111