Preoperative, intraoperative, and postoperative concepts to prevent infection for unicompartmental knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention

Background:

• Periprosthetic joint infection (PJI) is a rare but serious complication following unicompartmental knee arthroplasty (UKA).
• PJI can necessitate revision surgery and incurs substantial healthcare costs.
• Proactive measures are crucial to mitigate infection risk.

Purpose of the Study:

• To review and synthesize evidence on strategies for preventing PJI in UKA patients.
• To cover preoperative, intraoperative, and postoperative interventions.

Main Methods:

• Literature review and evidence synthesis.
• Discussion of risk factors including malnutrition, obesity, Staphylococcus aureus, smoking, HIV, and rheumatoid arthritis.
• Analysis of preventative measures such as skin preparation, laminar airflow, antibiotic administration, antimicrobial drapes, lavage, vancomycin powder, wound closure, thromboprophylaxis, and negative pressure wound therapy.

Main Results:

• Multiple patient-specific factors and surgical techniques influence PJI risk.
• Preoperative optimization, meticulous intraoperative protocols, and appropriate postoperative care are essential.
• Evidence supports various interventions in reducing infection rates.

Conclusions:

• A multi-faceted approach combining patient optimization and evidence-based surgical practices is key to minimizing PJI after UKA.
• Implementing these strategies can reduce revision rates and healthcare expenditures.