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���Our preoperative MRSA screening program identifies patients who are at high risk for infection and enters them into MRSA decolonization treatment program prior to surgery. Once those patients are identified and decolonized preoperatively, we also adjust their intraoperative and post-operative antibiotics to help further decrease their infection risk,��� Dr. Fitzgerald explains. For intra-operative infection control, joint replacement procedures at UHCMC are performed in clean-air laminar flow rooms where surgeons wear full-body ���space suits��� to limit contamination. The result is an infection rate of less than 0.5 percent. Like many other technically demanding medical procedures, research has shown that the level of training, experience and operative case volume of the surgeon is an important determinant of the rate of complications and outcome of joint replacement surgery. All of the orthopaedic surgeons on UH���s joint replacement and preservation team have completed subspecialty fellowship training at top medical centers. ���When you focus on a surgical procedure and do 100 to 200 or more a year, you become very proficient and your outcomes are improved,��� says William Petersilge, MD, who estimates the joint replacement surgeons at UHCMC perform about 1,100 joint replacements per year. In addition to Drs. Kraay, Fitzgerald and Petersilge, other members of the joint replacement team include Drs. Randall Marcus, chairman, Department of Orthopaedics UHCMC, Glenn Wera and Roger Wilber. Dr. Wilber is also part of the joint preservation team which includes Drs. Michael Salata, Donald Goodfellow and Brian Victoroff. Not surprisingly, hospital volume also has a similar effect on rate of complications and outcome. As volumes grow, so too does the level of experience and expertise of the nurses, technicians, and other support staff who work at the hospital. ���Because of our high volumes, we are able to have six OR nurses dedicated solely to joint replacement and preservation, PHOTOS COURTESY OF UNIVERSITY HOSPITALS For intra-operative infection control, joint replacement procedures at UHCMC are performed in clean-air laminar flow rooms where surgeons wear full-body ���space suits��� to limit contamination. The result is an infection rate of less than 0.5 percent.