How Orthopaedic Innovation Reduces Infection in Knee Replacement Surgery

A surgical site infection (SSI) happens when bacteria get into the incision made during surgery. While SSIs are quite rare in orthopaedic operations, they can unfortunately lead to:

• Longer hospital stays.
• The need for more treatments.
• A delayed recovery.

Preventing these infections is an absolute top priority for any dedicated surgical team, in line with guidance from organisations like the World Health Organization (WHO)¹.

Infection prevention begins well before the actual knee replacement surgery. Every patient at Orthopaedic Innovation undergoes a detailed pre-operative assessment designed to identify the individual risk factors and support the best possible outcome.

Key Pre-Operative Steps for Infection Control:

• Comprehensive health screening: We assess potential infection risks, such as uncontrolled diabetes or immune conditions. Controlling blood sugar levels for diabetic patients, encouraging smoking cessation and addressing nutritional deficiencies are crucial steps to enhance your body's natural defences.
• Pre-surgical bacterial screening and preparation: This includes screening for specific bacteria, such as Staphylococcus aureus, which can reside on the skin or in the nasal passages. Appropriate decolonisation treatments may be initiated if necessary. You may also be advised on specific antiseptic washes to use before your surgery to reduce skin bacteria.
• Antibiotic prophylaxis: We give you a precise dose of antibiotics intravenously just before your surgical incision is made. This preventative measure ensures effective antibiotic levels are present in your tissues at the critical moment, guarding against potential bacterial ingress.

This extensive preparation for knee replacement ensures a safer, faster procedure which is tailored to the patient’s individual needs and sets the stage for effective infection prevention.

A crucial part of reducing infection in knee surgery is minimising the time a patient spends in the theatre and ensuring an impeccably sterile environment. At Orthopaedic Innovation, our surgical team operates with meticulous preparation, where every detail is pre-planned and executed with precision.

Inside the Operating Theatre, our highly choreographed process includes:

• The use of pre-packed sterile instrument kits, some of which our surgeons have helped design specifically for orthopaedic procedures.
• Knee implants prepared and verified before the incision, minimising handling during the actual operation.
• Fixed team roles and positions for every staff member to eliminate unnecessary movement and maintain optimal sterility throughout the knee replacement procedure.
• A surgical “referee” on hand to ensure strict adherence to sterile protocols and quality checks.

This choreography means we complete the surgical procedure itself in approximately 30 minutes, contributing significantly to reduced exposure time for the patient. Less time in theatre unequivocally equals less risk of infection. This research is supported by findings published in medical journals, for example, studies on operating room time and infection risk available on PubMed².

Our minimally invasive approach is Orthopaedic Innovation's signature technique for knee replacement surgery, actively contributing to achieving very low complication rates. This advanced technique reduces infection risk through several critical factors:

• Smaller incision and muscle-sparing methods directly reduce soft tissue trauma and minimise bacterial exposure to the internal structures of the knee.
• Optimised operative time means significantly reduced airborne contamination within the sterile field.
• Digitally-guided accuracy ensures better fit and placement of implants, limiting complications that could create pathways for infection.
• Prophylactic antibiotics are administered precisely before incision to provide immediate protection at the surgical site.
• Emphasis on early mobilisation after knee surgery, which improves circulation and promotes healing, supporting the body's natural defences against infection.

Read further on our Knee Replacement page

At Orthopaedic Innovation, all of our orthopaedic procedures are co-led by internationally renowned consultants, most notably Dr Kristian Kley and Professor Adrian Wilson. Both operating on hundreds of knees every year, their combined expertise and teamwork bring distinct advantages for infection control in knee replacement surgery:

• Consistency and surgical precision across all procedures, leading to more predictable and safer outcomes.
• A peer-reviewed decision-making process for complex cases, ensuring every angle is considered.
• Deep experience with advanced orthopaedic software and minimally invasive techniques, which are key to reducing surgical invasiveness and associated risks.
• Extensive practical experience across numerous orthopaedic procedures each year, building a strong foundation of expertise.

The presence of two highly experienced surgeons allows the lead surgeon to be completely focused on the operation itself, undisturbed by other activities in the operating theatre. 

This total concentration allows for laser-focused precision. The surgeons are supported by a dedicated team of scrub nurses, anaesthetists, and surgical assistants, each with defined roles, all contributing to a smooth, sterile, and highly controlled environment for your knee surgery.

You can learn more about our surgical team in our blog: Who’s in the Operating Room? Meet the Expert Team Behind Your Knee Replacement Surgery

Reducing infection risk isn't just about sterilisation; it’s also fundamentally about minimising the time your body is exposed during knee replacement surgery. 

A streamlined surgical environment helps avoid complications while supporting faster healing and reducing exposure to potential pathogens.

While our team takes every precaution, your active participation is also vital for preventing infection following your knee replacement.

Key steps you can take include:

• Following all pre-operative instructions diligently.
• Maintaining excellent personal hygiene.
• Promptly reporting any concerns about your wound or general health to your care team.
• Meticulously adhering to post-operative wound care guidelines.
• Informing your dentist about your knee replacement: Antibiotics may be needed before certain dental procedures to avoid the chance of an infection spreading to the joint.

These crucial steps contribute significantly to a successful, infection-free recovery.