The incidence of deep prosthetic infections in a specialist orthopaedic hospital: a 15-year prospective survey

J Bone Joint Surg Br. 2006 Jul;88(7):943-8. doi: 10.1302/0301-620X.88B7.17150.


The Control of Infection Committee at a specialist orthopaedic hospital prospectively collected data on all episodes of bacteriologically-proven deep infection arising after primary hip and knee replacements over a 15-year period from 1987 to 2001. There were 10 735 patients who underwent primary hip or knee replacement. In 34 of 5947 hip replacements (0.57%) and 41 of 4788 knee replacements (0.86%) a deep infection developed. The most common infecting micro-organism was coagulase-negative staphylococcus, followed by Staphylococcus aureus, enterococci and streptococci. Of the infecting organisms, 72% were sensitive to routine prophylactic antimicrobial agents. Of the infections, 29% (22) arose in the first three months following surgery, 35% between three months and one year (26), and 36% (27) after one year. Most cases were detected early and treated aggressively, with eradication of the infection in 96% (72). There was no significant change in the infection rate or type of infecting micro-organism over the course of this study. These results set a benchmark, and importantly emphasise that only 64% of peri-prosthetic infections arise within one year of surgery. These results also illustrate the advantages of conducting joint replacement surgery in the isolation of a specialist hospital.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents / therapeutic use
  • Arthroplasty, Replacement*
  • Arthroplasty, Replacement, Hip
  • Arthroplasty, Replacement, Knee
  • Debridement / methods
  • Female
  • Hip Joint / microbiology
  • Hip Joint / surgery
  • Humans
  • Incidence
  • Knee Joint / microbiology
  • Knee Joint / surgery
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / microbiology*
  • Postoperative Complications / therapy
  • Prospective Studies
  • Prosthesis-Related Infections / epidemiology
  • Prosthesis-Related Infections / microbiology*
  • Prosthesis-Related Infections / therapy
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / therapy
  • Staphylococcus aureus / isolation & purification


  • Anti-Infective Agents