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I have a thread on this in the Library > general FAQs Late onset infection in joint replacements
And a recent post by Barbs was interesting: Prophylactic Use of Antibiotics prior to Dental Procedures.
All in all, no-one knows how these infections occur though in my own opinion, any infection that occurs within 3-4 months is highly likely to be sourced at the time of surgery.
One or two other things Barb left out was the highly intensive sterile air system which is a canopy over the operating table which blows 99.5% sterile air over the patient thereby preventing any contamination from the environment, including from the personnel present. Also the surgical team wears cover-all gowns and hoods. These are by far the most effective protection for the patient at the time of surgery - that and the pre-op showering for the last few days prior.
I don't remember seeing a canopy over the operating table in the hospital I had my first TKR in. Personnel didn't wear that kind of gear either, just gowns, caps, masks and gloves!! And whats with the pre op showering? never had any instruction on that, just regular showers were all I had.
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