The role of antibiotics in preventing infections following total hip replacement.

The incidence of infection in hip replacement surgery from the MRC trial was less than 1% and it should be the aim of every centre to remain within this range. Some 50,000 total hip replacements are performed in the United Kingdom each year, and even this incidence would produce a significant number of revision arthroplasties. Perhaps the ideal combination of prophylaxis is to use an ultraclean air system together with short-course high-dose antibiotics delivered at the time of surgery. However, probably more important than anything else is the enforcement of a theatre discipline; large numbers of people should be prevented from moving around in the theatre and the theatre should remain a closed system allowing the clean air plenum ventilation to function.