The problem of infection in total prosthetic arthroplasty of the hip

In summary, deep wound infection carries a special and disastrous significance for the patient with a total joint prosthesis. Such patients seem to be at greater than usual risk of infection, and special precautionary measures to prevent it are not only justified but imperative. These include careful preoperative preparation; special attention to rigid and exacting operative techniques for control of potential exogenous contaminants; sensible preoperative, intraoperative, and postoperative antibiotic prophylaxis for control of potential endogenous cantaminants; and continued supervision of the patient throughout the postoperative years so as to prevent potential metastatic infection from other primary sources. Pre-existing and active infections of the hip constitute contraindications to total prosthetic arthroplasty, but these rules may be suspended in certain special situations provided that the patient is willing to cooperate with the arduous and prolonged program of treatment, and fully understands the special risks involved.