AIM: To analyse prospectively the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonisation and infection in wounds and surgical vacuum drains. METHODS: The study group was 100 patients undergoing primary total hip and total knee replacements in a single orthopaedic unit. RESULTS: Two patients had undergone revision joint surgery within the same unit in the year prior to the study due to confirmed MRSA infection. Following a change in the unit's infection control policy, joint replacement surgery continued within the unit even when there were cases of active MRSA present on the same ward. None of the patients undergoing joint replacement grew MRSA in their postoperative drain tips or wound cultures. CONCLUSIONS: It is safe to continue with joint replacement surgery when other patients on the same ward have active MRSA as long as strict infection control measures are followed as outlined.