A critical review of antibiotic prophylaxis in orthopedic surgery

A review of controlled clinical trials of antibiotic prophylaxis in orthopedic surgery is presented. Two well-designed and well-conducted studies support the efficacy of prophylactic antibiotics for prevention of wound infection in surgery of hip fractures. Several studies support a role for prophylactic antibiotics in total hip replacement, but it should be noted that equally low rates of wound infection have been attained in hypersterile operating theaters without any prophylactic antibiotics. The role of antibiotic-containing cement in total hip replacement surgery needs further critical evaluation.