Problem: Deep infection after hip- or knee-replacement is a severe complication that may lead to implant removal or arthrodesis.

Aim: In our hospital intraoperativ subcoutanues culture samples were taken before wound closure. We wanted to know if positive cultures are of any predicitive value in relation to early or late periprosthetic infection. If so, is there a consequence in treatment ? Also costs were analysed.

Material and methods: In 2002 we performed 167 primary hip and knee replacements. We retrospectivaly analysed the outcome of 159 cases over a follow-up period of up to 28 month.

Results: In 96.8% of the cases a culture sample was taken. Of these 5.8% showed germ growth. In only 4 cases positive cultures were followed by a change in treatment, either antibiotics or revision. Of nine patients with revision surgery only one had a positive culture. Four cases showed germ growth during revision surgery after sterile cultures during implantation. Most often different bacterias were found in primary and revision surgery. In 1.25% deep periprosthetic infection occured. One required second stage knee-replacement, one case ended in resection arthroplasty.

Conclusion: Intraoperative culture sample is of no predictive value in primary joint replacement. There is no correlation between positiv cultures and indication for revision surgery. However costs for culture analysis and antibiotics are low compared to the increase of expense caused by periprosthetic infections.

Aims: The purpose of the study was to obtain long-term results after total hip arthroplasty (THA) with cemented titanium stems typ Mueller-Geradschaft. Methods: 91 patients with a total of 110 THA were clinically and radiologically examined after an average follow-up of 9,5 years (9 to 11). The recruitment was 84%. The Harris score was determined clinically. Radiologically the directly postoperative radiographs were compared to the control radiographs according to the recommendations of Gruen et al. and Johnston et al. Results: In 1 cases (1%) a septical complication appeared after two years which was treated in two-stage surgery. Revisions after aseptic loosening have been carried out in 4 cases (4%). No other cases showed evident signs of loosening and applied revision surgery. Clinically, in all of those 4 cases of aseptic loosening the Harris score remained above 75 points. Altogether in 36 cases more than one RLL was ascertained which were only be observed in zones 1, 7, 8, 14. The body weight was significantly higher (82 kg; d=2.4) in the 4 revisions than in cases without RLL, especially the ratio body weight to surface of the stem was clearly different (1.5 kg/cm2 versus 1 kg/cm2; p< 0.005) in the two patients groups. This did not apply to sex, activity, size or kind of stem, Harris-score, ectopic ossification or body-weight index. Conclusions: Cemented titanium stem protheses showed good long-term results. The biggest possible stem should be implanted. Periodically, radiological controls of THA are necessary because the subjective findings of patients does not correlate to the state of prosthesis loosening