Infection risk stratification in total knee joint arthroplasty using a new scoring system.

Area of Science:

• Orthopedic Surgery
• Infectious Disease
• Biostatistics

Background:

• Periprosthetic joint infection (PJI) is a severe complication following total knee arthroplasty (TKA).
• PJI significantly increases healthcare costs, morbidity, and mortality.
• Effective preoperative risk stratification for PJI is needed.

Purpose of the Study:

• To develop and validate a prognostic scoring system for preoperative risk stratification of TKA patients.
• To identify modifiable risk factors associated with PJI.
• To reduce PJI rates through targeted preoperative interventions.

Main Methods:

• A scoring system was developed based on preoperative variables.
• 150 patients undergoing primary TKA were included (60 retrospective, 90 prospective).
• Patients with a score of 4 or higher were advised to optimize risk factors before surgery.

Main Results:

• In the retrospective group (Group I), 4 out of 9 patients (P<0.05) with a score above 4 developed PJI.
• None of the prospective patients (Group II) who underwent risk factor optimization developed PJI.
• The scoring system demonstrated objective preoperative risk stratification capabilities.

Conclusions:

• The developed scoring system effectively stratifies TKA patients by PJI risk.
• Preoperative identification and optimization of risk factors can significantly decrease PJI incidence.
• This tool aids in proactive patient management to improve TKA outcomes.