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Published on: December 3, 2017
Infection after knee arthroplasty a prospective study of 1509 cases
David Chesney1, Jim Sales, Robert Elton
1Department of Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
Abstract:
We report a prospective study of 1509 consecutive total knee arthroplasties looking at risk factors for infection in modern surgical practice. The overall deep infection rate was 1%. A further 51 patients had a superficial infection (3.3%). Statistical analysis revealed no correlation between risk of infection and age and sex. Those who had poor health as assessed by the American Society of Anesthesiologists score had no increased risk of infection. Neither did patients undergoing arthroplasty for rheumatoid arthritis. Diabetic patients and those with morbid obesity (body mass index, >40 kg/m(2)) had an increased odds ratio for deep and superficial infection, but these results did not reach statistical significance.
Insights
This study on total knee arthroplasty found a 1% deep infection rate. While age, sex, and health status were not risk factors, diabetes and morbid obesity showed a trend towards increased infection risk.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Epidemiology
Background:
- Total knee arthroplasty (TKA) is a common procedure.
- Understanding infection risk factors is crucial for improving patient outcomes.
- Modern surgical practices aim to minimize complications like infection.
Purpose of the Study:
- To identify risk factors for deep and superficial infections after total knee arthroplasty.
- To evaluate the impact of patient demographics and comorbidities on infection rates.
- To assess infection risks in the context of contemporary surgical techniques.
Main Methods:
- Prospective study design.
- Inclusion of 1509 consecutive total knee arthroplasty patients.
- Statistical analysis to determine correlations between risk factors and infection.
Main Results:
- Overall deep infection rate was 1%; superficial infection rate was 3.3%.
- No significant correlation found between infection risk and age, sex, American Society of Anesthesiologists score, or rheumatoid arthritis.
- Diabetic patients and those with morbid obesity (BMI >40 kg/m²) showed a trend towards increased infection odds, but not statistically significant.
Conclusions:
- Age, sex, general health status, and rheumatoid arthritis are not significant risk factors for TKA infection.
- Diabetes and morbid obesity may be associated with increased TKA infection risk, warranting further investigation.
- Maintaining low infection rates in TKA requires ongoing surveillance and potentially targeted preventive strategies.