Abstract: OBJECTIVE To conduct a follow-up study of effect of antibiotic bone cement prosthesis on prevention of postoperative secondary deep infection in elderly patients undergoing total hip replacement. METHODS The clinical data of 81 patients who underwent primary total hip arthroplasty in the hospital from Jan 2012 to Mar 2015 were analyzed; 39 patients who were treated with antibiotic bone cement prosthesis were assigned as the observation group, and 42 patients who were treated with conventional bone cement prosthesis were set as the control group. RESULTS The Harris score of the observation group was significantly higher than that of the control group (P<0.05). The levels of serum PCT and D-D of the two groups of patients were significantly decreased with the time after the surgery; the levels of serum PCT and D-D were significantly higher after the surgery for 1, 7 days than before the surgery (P<0.05). The PCT level of the observation group was lower than that of the control group after the surgery for 1, 7 days, however, the D-D level of the observation group was lower than that of the control group after the surgery for 7, 14 days (P<0.05). A 18-month follow-up that was conducted for the two groups of patients after the surgery showed that there was no case of infection in the observation group and 7 cases of secondary deep infection in the control group, the infection rate was 16.67%. The patients who were infected with gram-positive bacteria were dominant. The postoperative 18-month cumulative infection rate was calculated by using Kaplan-Meier curve, the cumulative infection rate of the observation group was significantly lower than that of the control group (P=0.008). CONCLUSION The antibiotic bone cement prosthesis can achieve significant curative effect on the elderly patients undergoing the total hip replacement and remarkably reduce the risk of postoperative deep infection.