In a consecutive series of 298 total hip-joint replacements performed by
a single surgeon using a standard operating room, early deep infection was
eliminated by simple inexpensive methods of controlling contamination in
the operating room. Settling-plate monitoring revealed an average of 4.8
colonies of bacterial growth per hour of exposure. All patients received
prophylactic antibiotics. One patient had a superficial wound infection
which was controlled with antibiotic therapy. No deep infections were
encountered in the 252 hips followed for two to five years after operation.
We conclude that total hip arthroplasty can be performed in the standard
operating room without undue risk of infection by consistently employing
strict measures of operating-room discipline to limit contamination.