The incidence of infection after primary arthroplasty is low. However, with the increasing number of arthroplasties being performed the prevalence of infection is increasing. The pattern of infecting organisms following total joint arthroplasty has changed and gentamicin resistant organisms are becoming increasingly common. Vancomycin added to bone a cement carrier can, with adequate surgical debridement be very effective in the eradication of established resistant infection. We report the results of its use in 33 patients with 26 infected hip and 7 infected knee arthroplasies. 32 patients remain clinically and radiologically free of infection after a mean follow-up of 67 months. There was one recurrence of infection and there were three positive second stage cultures of uncertain significance. Vancomycin is potentially a very useful tool in the management of deep infection following arthroplasty surgery.

Although the incidence of infection associated with hip and knee prostheses is low, with the increasing number of arthroplasties being carried out, the total number of such cases is increasing. The pattern of infecting organisms after total joint arthroplasty has changed and gentamicin-resistant organisms are becoming increasingly common. In conjunction with surgical debridement, vancomycin added to a bone-cement carrier can be very effective in the treatment of infection caused by such organisms.

We report the results of its use in proven deep infection in 26 hip and seven knee arthroplasties. After a mean follow-up of 67 months, 32 patients remained clinically and radiologically free from infection. There was one recurrence and positive second-stage cultures of uncertain significance in three other patients. Vancomycin is potentially very useful in the management of deep infection after arthroplasty.