Risk factors related to infections in primary hip and knee arthroplasties

Abstract

Joint arthroplasty is a safe and effective procedure that improves the quality of life by restoring pain-free function in patients with hip and knee osteoarthritis. However, despite the widely reported success of the procedures, prosthetic joint infection (PJI), as a rare but well-recognized complication, affects some patients after hip or knee joint arthroplasty. As is well known, PJI is associated with extremely poor postoperative results and a high incidence of mortality, especially in elderly patients. Objective: to identify the medical risk factors most associated with PJI.

56 Patients with PJI after receiving primary prostheses were included, of which 32 hip arthroplasties and 24 knee arthroplasties between January 2017 and March 2020, regardless of age, sex or type of disease. The following risk factors obesity, malnutrition, diabetes and uncontrolled diabetes mellitus, cardiovascular disorders, rheumatoid arthritis, preoperative anemia, chronic renal failure, smoking, alcoholism, and depression were taken into account.

It was found that obesity (BMI >30) was present in 25 patients (44.6%), DBT in 22 patients (39.2%), smoking 22 patients (39.2%), alcoholism in 10 patients (17.8%), cardiovascular pathology in 11 patients (19.6%), rheumatoid arthritis 5 patients (8.9%), preoperative anemia 6 (10.7%), renal failure 4 patients (7.14%), malnutrition 7 (12.5%), depression 7 (12.5%), ASA > 3 28 patients (50%).

The most frequent risk factors for PJI were BMI > 30, smoking, diabetes, and ASA score >3. This requires early detection and adequate treatment of these risk factors prior to surgery. These findings are important for the development of prevention strategies for PJI.