Preventing infection

SIR – While your article (October 23) on antimicrobial resistance highlights an important issue in healthcare, the suggestion that hip- and kneereplacement operations are dangerous flies in the face of the evidence.

The National Joint Registry shows that infection rates after hip and knee replacements remain low. Most patients having a joint replacement at the age of 70 should expect it to last their natural lifetime. Antimicrobial resistance is a real healthcare risk, but patients can be confident that joint replacement remains the best form of pain relief for end-stage arthritis.

Surgeons and all healthcare teams associated with hip- and knee-replacement surgery are acutely aware of the need to prevent infection. Standard practice includes screening patients before surgery for skin carriage of bacteria; using ring-fenced beds for patients having joint-replacement surgery; dedicated ultra-clean-air theatres for surgery; and appropriate doses of antibiotics prior to surgery. These practices are combined with meticulous surgical technique and good theatre and infection-prevention discipline.

Professor John Skinner

Treasurer, British Orthopaedic Association Andrew Manktelow

President, British Hip Society Professor Andrew Price

President, British Association for Surgery of the Knee Professor Philip Turner

President, British Orthopaedic Association