Antibiotic Prophylaxis in Joint Arthroplasty: Do we get it right?

Abstract

Purpose: The goal of this study was to investigate whether our institution adhered to current guidelines 
for the use of prophylactic antibiotics in hip and knee arthroplasty.  
Type of Study: Retrospective case series.  
Methods: Data on the administration of prophylactic antibiotics for 798 consecutive total hip 
arthroplasty, total knee arthroplasty, and hip hemiarthroplasty procedures were recorded. All primary 
and revision procedures were included.  This data has been analysed to assess if antibiotic prophylaxis 
administration has followed the current American Academy of Orthopaedic Surgeons guidelines.  
Results:  Prophylactic antibiotics were correctly administered in 266 cases (91.4%) of THR, 259 cases 
(92.5%) of TKR, 148 cases (86%) of hip hemiarthroplasties, 34 cases (82.9%) of revision THR and 13 
cases (92.9%) of revision TKR. 
Conclusions: The benefit of appropriate prophylactic antibiotic administration in joint arthroplasty is 
well established and documented in the literature1.  This study demonstrates that 9.8% of patients 
undergoing hip and knee arthroplasty procedures are not receiving antibiotic prophylaxis as per AAOS 
guidelines. This highlights that there is scope for improving current practice and demonstrates the 
need for clinical audit to ensure that best practice is being undertaken.  
Level of evidence: Level IV, case series