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Article summary:

1. Peri-prosthetic joint infection (PJI) in primary total hip and total knee arthroplasty range between 0.3% and 1.9%, and up to 10% in revision cases, causing significant morbidity, economic burden, and personal cost to the affected patient.

2. Reducing the risk of surgical site infection (SSI) in primary hip and knee arthroplasty requires a multi-faceted strategy including pre-operative patient bacterial decolonization, screening and avoidance of anaemia, peri-operative patient warming, skin antisepsis, povidone-iodine wound lavage, and anti-bacterial coated sutures.

3. This article also considers newer concepts such as the influence of bearing surfaces on infection risk, as well as current controversies such as the potential effects of blood transfusion, laminar flow, and protective hoods and suits on infection risk.

Article analysis:

The article is generally reliable in its reporting of information regarding prevention of infection in primary THA and TKA surgeries. The authors provide a comprehensive overview of the various strategies that can be employed to reduce the risk of PJI or SSI during these procedures. The article is well researched with references to relevant studies that support their claims. Furthermore, they provide an unbiased view by presenting both sides of any controversial topics discussed in the article.

However, there are some areas where the article could be improved upon. For example, while it does discuss newer concepts such as bearing surfaces on infection risk, it does not provide any evidence for these claims or explore counterarguments that may exist for them. Additionally, while it does mention potential risks associated with certain strategies such as blood transfusions or laminar flow systems, it does not go into detail about how these risks can be mitigated or avoided altogether. Finally, there is no discussion about how different types of patients may respond differently to certain strategies or treatments which could lead to different outcomes depending on individual circumstances.