Postoperative decrease in serum albumin as predictor of early acute periprosthetic infection after total knee...

Area of Science:

• Orthopedic Surgery
• Biochemistry
• Infectious Disease

Background:

• Hypoalbuminemia (serum albumin [SA] < 3.5 g/dL) increases surgical complication risk.
• Postoperative infection rates are higher in patients with hypoalbuminemia after total knee arthroplasty (TKA).

Purpose of the Study:

• To analyze preoperative and postoperative serum albumin (SA) dynamics in patients who developed acute periprosthetic infection within 4 weeks of TKA.
• To evaluate the relationship between SA levels and early acute infection after TKA.

Main Methods:

• Retrospective analysis of 490 TKAs (314 patients).
• Comparison of serum albumin (SA) levels (preoperative [SA0] and 1 week postoperative [SA1W]) in patients who developed infection (STG) versus those who did not (non-STG).
• Analysis of patient and operative parameters influencing SA.

Main Results:

• No significant differences in SA-influencing parameters between STG and non-STG.
• Patients in STG did not have SA0 or SA1W below 3.5 g/dL.
• Significantly greater reduction in the amount and rate of SA from pre- to post-surgery in STG compared to non-STG.

Conclusions:

• Serum albumin (SA) dynamics, specifically a greater reduction in amount and rate, were observed in patients with early acute periprosthetic infection after TKA.
• No correlation was found between SA levels at SA0 or SA1W and early acute infection.
• Further investigation into the 3.5 g/dL SA threshold for predicting acute early infection is warranted.