Post-operative infection is a serious complication in any surgical procedure, particularly in arthroplasty, presenting limited options for both the surgeon and the patient. The use of antibiotic prophylaxis in arthroplasty remains a therapeutic gray area, with no clear consensus on the appropriate role, timing, dosage, or type of antibiotics. Large studies generally report an infection rate of 1-2% for arthroplasty. Leading prosthesis manufacturers emphasize the importance of disposable instrument sets, sterile helmet systems, and modular operating theaters (OTs) for optimal outcomes, particularly in arthroplasty. Despite our operating conditions being far from ideal, we have managed to maintain a surprisingly low infection rate. Our OT is a basic room without laminar flow, specialized flooring, or advanced air-conditioning. We use reusable, autoclaved cotton gowns and sheets, and ensure that the OT and patient rooms are fumigated before every surgery. For prophylaxis, we administer Linezolid and Amikacin. We conducted a review of 173 consecutive arthroplasty patients (235 joints, including hips and knees) with a minimum follow-up of one year. The results suggest that our infection rate (<1%) is comparable to, if not better than, the world’s leading centers, and this has been achieved at just a fraction of the cost (<$1100 vs. ~$55,000). This raises important questions about the factors contributing to infection rates and may offer valuable insights for smaller centers without state-of-the-art facilities, encouraging them to consider offering joint replacement procedures.