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Preoperative optimization to prevent periprosthetic joint infection in at-risk patients

Vincent Wk Chan1, P K Chan1, H Fu1

  • 1Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, 26473Queen Mary Hospital, Hong Kong, SAR, China.

Journal of Orthopaedic Surgery (Hong Kong)
|August 28, 2020
PubMed

Insights

Preventing periprosthetic joint infection (PJI) after joint replacement is crucial. This review focuses on optimizing modifiable risk factors during preoperative assessment to reduce PJI incidence.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Surgical Outcomes

Background:

  • Periprosthetic joint infection (PJI) is a severe complication following total joint arthroplasty.
  • The incidence of PJI is rising globally, posing a significant economic burden.
  • Complete eradication of PJI is unlikely; therefore, risk factor management is essential.

Purpose of the Study:

  • To review current literature on preoperative assessment of modifiable risk factors for PJI.
  • To share institutional experience and practical approaches for preoperative optimization to reduce PJI.
  • To highlight the importance of preoperative strategies in preventing PJI.

Main Methods:

  • Literature review of preoperative risk factors for PJI.
  • Analysis of institutional practices for preoperative optimization.
  • Focus on modifiable risk factors amenable to intervention before surgery.

Main Results:

  • Preoperative assessment allows for screening and optimization of patient comorbidities.
  • Identifying and managing modifiable risk factors can significantly impact PJI rates.
  • Institutional experience demonstrates the feasibility of preoperative optimization protocols.

Conclusions:

  • Preoperative optimization is a key strategy in reducing PJI after total joint arthroplasty.
  • A multidisciplinary approach to managing modifiable risk factors is recommended.
  • Further research into effective preoperative interventions for PJI prevention is warranted.

Keywords:
joint replacementsperiprosthetic joint infectionpreoperative optimizationtotal joint arthroplasty

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