Incidence of deep sepsis in total hip arthroplasty. Survivorship analysis over 17 years from one hospital.

Of 3,051 total hip arthroplasties (THA) performed between January 1970 and August 1986, 47 hips in 43 patients developed deep periprosthetic infection. This population was divided temporally into three groups based on changes in our perioperative antiseptic technique. Using survivorship analysis, a significant decrease in the sepsis rate in primary THA was seen in the period since 1974 (P less than .03). Comparing all surgeries in the most recent cohort (1980-1986) to others by a Cox Proportional Hazards model (which accounts for differences in follow-up results), indicates that the relative risk of sepsis has decreased by half in this latest group. Contemporary perioperative antiseptic techniques have lowered the risk of infection in THA. Further significant decreases in sepsis incidence will likely require a reduction in the incidence of infection acquired outside the operating room.