Deep infection in total hip arthroplasty that presents more than a year after the procedure may occur as the result of hematogenous seeding of the implant by organ isms originating from a distant site. Infections of the tract, gastrointestinal tract, and mouth are most frequently implicated as sources. Because of this phenomenon, patients who have undergone total hip arthroplasty are counseled to seek rapid treatment of any suspected bacterial infection. Routine prophylactic antibiotic treatment is also recommended for any invasive procedure that could result in a hematogenous spread of bacteria. Established deep infection in these cases has a tendency to persist unless all prosthetic material is removed, infected tissues are thoroughly debrided, and appropriate antibiotic treatment is administered. Some surgeons have advocated immediate reimplantation of another prosthesis at the time of the initial debridement. Most defer such revisions for 3 to 12 months, however, and proceed only if the infection appears clinically qui- escent. Subsequent hip aspirates must be culturenegative before revision arthroplasty attempted