Infection

Risk factors for periprosthetic joint infection (PJI) or surgical site infection (SSI) include skin lesions, oral hygiene (dental caries), urinary tract infections, smoking, low body weight, obesity, hepatic dysfunction, renal dysfunction, anemia, diabetes mellitus, and poor nutrition. These factors should be corrected preoperatively if possible. Past trauma or hip surgery is also considered a risk factor. At ICM2018, there were conflicting statements about whether carriers of Staphylococcus aureus in the nasal cavity and on the skin should be investigated and if the bacteria should be eradicated. Finally, the answer was inconclusive. However, a recent meta-analysis showed that screening and eradication of Staphylococcus aureus has a significant effect on infection prevention [1]. In particular, patients with diabetes are at a higher risk for nasal methicillin-resistant Staphylococcus aureus (MRSA) carriage [2].The recommended prophylactic antimicrobial treatment for total hip arthroplasty (THA) in adults is 2 g of cefazolin every 4 h (ICM 2018). However, if the patient weighs ≥120 kg, 3 g should be considered. The need for a single or additional dose is controversial, and the addition of vancomycin should be considered in patients with MRSA.