Acta Ortopédica Mexicana

Montalvo GM, Velutini KJA, León PM, Zamora MPM
Review of the actions in prevention of infections in total arthroplasty of hip
Acta Ortop Mex 2007; 21 (6)

Language: Español
References: 27
Page: 328-332
PDF: 102.39 Kb.

[Fulltext - PDF]


The prophylactic use of antibiotics when a hip replacement procedure is performed has been subject of intense debate. Prevention of such an infection is complex, with many unresolved issues that require considerable investigation. The attentive application of reasonable principles of infection control with the goals of optimization of the wound environment, augmentation of the host response, and minimization of bacterial contamination in the preoperative, and postoperative time-period is essential to that over-all reduction of the frequency of infection. We present the antibiotic prophylaxis used in the American British Cowdray Medical Center between January 1999 to July 2003. after hip arthroplasty in 532 patients. The main antibiotic used was cefalotin in 53.76% of the cases, but only in 3.2 % a one day prophylaxis treatment recommended in the literature is used, with septic loosening of 3.9%.

Key words: arthroplasty, hip, antibiotic prophylaxis.


  1. Masterson E, Masri B, Clive P: Instructional Course Lecture. The American Academy of Orthopaedic Surgeons. J Bone and Joint Surg Am Nov 1997; 79A(11): 1740-9.

  2. Hope P, Krisstinsson K, Norman P: Deep infection of cemented total hip arthroplasties caused by coagulase negative staphylococci. J Bone and Joint Surg Am 989; 71-B(5): 851-5.

  3. Costertron J, Lewandowski Z, Caldwell DM: Microbial biofilms. Ann Rev Microbiol 1995; 49: 711-45.

  4. Oga M, Sugioka, Hobgood: Surgical biomaterials and differential colonization by Staphylococcus epidermidis. Biomaterials 1988; 9: 285-9.

  5. Moynhan B: Infection acquired in hospitals. Lancet 1980; 2: 885.

  6. Bryan C, Mogan S, Caton R: Cefazolin versus cefamandole for prophylaxis during total joint arthroplasty. Clin Orthop 1988; 228: 117-22.

  7. Jiranek, Hanssen: Antibiotic-Loaded bone cement for infection prophylaxis in total joint replacement. J Bone and join Surg Am 2006; 88: 2487-2500.

  8. Phillips C, Losina E: Incidence rates of dislocation, pulmonary embolism and deep infection during the first six months after elective total hip replacement. J Bone Joint Surg Am 2003; 85: 20-6.

  9. Patel J, Walsh M, Sehgat B, Preston C. Factors Associated with prolongated wound drainage after primary total hip and knee arthroplasty. J Bone Joint Surg Am 2007; 89: 33-8.

  10. Evrard J, Doyan F, Acar J: Two day cefamandole versus five-day cephazolin prophylaxis in 965 hip replacements. Report of multicentre double blind randomized trial. Int Orthop 988; 12: 69-73.

  11. Fitzgerald R, Thompson R: Current concepts review. Cephalosporin antibiotics in the prevention and treatment of musculoskeletal sepsis. J Bone Joint Surg 1983; 65-A: 1201-5.

  12. Mauerhan D, Nelson D, Smith D: Prophylaxis against infection in total joint arthroplasty. One day of cefuroxime compared with three days of cefazolin. J Bone and Joint Surg 1994; 76-A: 39-45.

  13. Classen D, Evans R, Pestotnik: The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. New England J Med 1992; 326: 281-6.

  14. Wymenga A, Van Horn, Theeuwes A: Cefuroxime for prevention of postoperative coxitis. One versus three doses tested in a randomized multicenter study of 2651 arthroplasties. Act Orthop Scand 1992; 63: 19-24.

  15. Gross P, Barrett T, Dellinger E: Purpose of quality standards for infectious diseases. Infectious diseases Society of America. Clin Infec Dis 1994; 18: 421.

  16. Goldner J, Allen B: Ultraviolet light in orthopaedic operating rooms at Duke University. Thirty five years experience. Clin Orthop 1973; 96: 195-203.

  17. Nelson J, Glassbunr A, Talbott R: Clean room operating rooms. Clin Orthop 1973; 96: 179-87.

  18. Ritter M, Eitzen H, French M: The operating room environment is affected by people and the surgical face mask. Clin Orthop 1975; 111: 147-50.

  19. Giliam D, Nelson C: Comparison of one step iodophor skin versus traditional preparation in total joint surgery. Clin Orthop 1990; 250: 258-60.

  20. Strange-Vognsen, Klareskov B: Bacteriologic contamination of suction tips during hip arthroplasty. Act Orthop Scand 1988; 59: 410-1.

  21. Fletcher N, Sofianos D, Brantling M. Prevention of perioperative infection. J Bone Joint Surg Am 2007; 89: 1605-18.

  22. Benjamin J, Volz R: Efficacy of a topical antibiotic irrigant in decreasing or eliminating bacterial contamination in surgical wounds. Clin Orthop 1984; 184: 114-7.

  23. Nelson C, Bergfeld J, Schwartz J: Antibiotics in human hematoma and wound fluid. Clin Orthop 1975; 1098: 138-44.

  24. Chu C, Williams D: Effects of physical configuration and chemical structure of suture materials on bacterial adhesion. A possible link to wound infection. Am J Surg 1984; 147: 197-204.

  25. Estrada R, Tsukayama D, Gustilo R: Management of total hip arthroplasty infections A prospective study of 108 cases. Orthop Trans 1993-1994; 17: 1114-5.

  26. Blackburn W, Alarcón G: Prosthetic joint infections. A role for prophylaxis. Arthrit Rheumat 1991; 34: 110-7.

  27. Sullivan P, Johnston R, Kelley S: Late infection after total hip replacement. J Bone and Joint Surg 1990; 72-A: 121-3.