A Bone & Joint Journal annotation reviews how prevention of periprosthetic joint infection has developed since major guidelines appeared a decade ago, and summarises current perioperative recommendations. The authors note that high-quality evidence is still limited in many areas.
The value of the update is in auditing what a unit actually does. Several measures are long established: optimising glucose control, stopping smoking, treating active skin and dental infection before surgery, and giving prophylactic antibiotics in the right window. Others remain contested and depend on local practice.
Periprosthetic infection is among the most serious complications of arthroplasty, and most prevention happens before the patient reaches theatre. A preoperative checklist that is actually followed is likely worth more than any single new measure.
- Check glucose control and smoking status at the decision-to-operate visit, not on admission
- Look for and treat skin, urinary and dental infection before elective arthroplasty
- Confirm prophylactic antibiotic timing is recorded for every case
- Audit your infection rate and compare it against your prevention checklist
- Read the annotation against your own protocol to identify gaps
Why it matters
Most of what prevents periprosthetic infection happens weeks before surgery, where checklists are often weakest.
Don't overread it
An expert annotation; many recommendations still rest on limited high-quality evidence.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for orthopaedics, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free