BOA, BHS and BASK respond to Daily Telegraph article on antimicrobial resistance affecting routine operations

On 23rd October the Daily Telegraph published an article: ‘Antibiotic-resistant superbugs creating deadly risks for hip and knee operations’.  Based on a new Public Health England (PHE) report, it stated that antimicrobial resistance is creating a threat to routine procedures, singling out hip and knee operations in the headline.

The BOA, BHS and BASK sent a Letter to the Editor of the Telegraph refuting the headline by quoting statistics from the NJR, which the paper published on 27 October.  The full Letter to the Editor sent to the Telegraph is below:

Dear Editor

We were dismayed to read the alarmist headlines above Tuesday’s (23rd October) article on antimicrobial resistance. While your article highlights an important issue in healthcare, the suggestion that hip and knee replacement operations are dangerous or “lethal” flies in the face of the evidence.

The National Joint Registry shows the infection rates after hip and knee replacement remain low and most patients having a joint replacement at age 70 should expect it to last their natural lifetime. Antimicrobial  resistance is a real healthcare risk but we at the British Hip Society (BHS), British Association for Surgery of the Knee (BASK) and the British Orthopaedic Association (BOA) think it’s important to reassure your readers that patients can be confident that joint replacement remains the best form of pain relief for end stage arthritis. Hip and Knee Replacement are safe, effective, reliable and reproducible operations that should continue to enjoy the high levels of patient, commissioner  and health care provider confidence that they deserve and the evidence fully supports.

The data you reported from Public Health England show the important issues of antibiotic resistance and the need for all to be vigilant. Antibiotic stewardship is vitally important in hospitals and you rightly are increasing awareness that antibiotics are potent drugs that are only effective when used appropriately.

Surgeons and all healthcare teams associated with hip and knee replacement surgery are acutely aware of the need to prevent infection. Standard practice includes screening patients before surgery for skin carriage of bacteria, using ring fenced beds for patients having joint replacement surgery so they are nursed away from patients with known or suspected infections, dedicated ultra clean air theatres for surgery, prophylactic antibiotics given correctly prior to surgery in appropriate doses to minimise infection risks combined with meticulous surgical technique and good theatre and infection prevention discipline.

Yours faithfully,

Professor John Skinner, Treasurer British Orthopaedic Association
Mr Andrew Manktelow, President British Hip Society
Professor Andrew Price, President British Association for Surgery of the Knee
Professor Philip Turner, President British Orthopaedic Association