Infection of a total joint arthroplasty is a major complication that requires careful investigation andpreoperative planning before further surgery, there are not areas where is clear unambiguous evidence to guide surgeons. We are currently faced with an increasingly complex case mixed, with a higher prevalence of immunocompromised patients, comorbidities and antibiotic-resistant bacteria. The use of antibiotic prophylaxis in articular replacement surgery has been shown to be beneficial. The most common organisms that cause deep wound infection are Staphylococcus aureus and coagulase-negative staphylococci such as Staphylococcus epidermidis. Therefore either cefazolin or cefuroxime should be used in conjunction with hip or knee arthroplasty. A prompt diagnosis permits early treatment. In the absence of a perfect test, a combined approach using the quadruple assessment of clinical evaluation,serological investigation (V/S, PCR), diagnosis imaging and microbiological analysis should enable the diagnosisof infection to be made with a high degree of confidence. Every effort should be made to achieve a definitive microbiological diagnosis. Therefore a preoperative aspiration should be performed and repeated if negative in the face of a high index of suspicion.

Infection of a total joint arthroplasty is a major complication that requires careful investigation andpreoperative planning before further surgery, there are not areas where is clear unambiguous evidence to guide surgeons. We are currently faced with an increasingly complex case mixed, with a higher prevalence of immunocompromised patients, comorbidities and antibiotic-resistant bacteria. The use of antibiotic prophylaxis in articular replacement surgery has been shown to be beneficial. The most common organisms that cause deep wound infection are Staphylococcus aureus and coagulase-negative staphylococci such as Staphylococcus epidermidis. Therefore either cefazolin or cefuroxime should be used in conjunction with hip or knee arthroplasty. A prompt diagnosis permits early treatment. In the absence of a perfect test, a combined approach using the quadruple assessment of clinical evaluation,serological investigation (V/S, PCR), diagnosis imaging and microbiological analysis should enable the diagnosisof infection to be made with a high degree of confidence. Every effort should be made to achieve a definitive microbiological diagnosis. Therefore a preoperative aspiration should be performed and repeated if negative in the face of a high index of suspicion.