Diabetes, Inflammatory Markers, and Tissue Thickness in Septic and Aseptic Hip Revision Surgeries

BACKGROUND Septic and aseptic loosening are the most common indications for revision hip arthroplasty (RHA), and infection-related revisions pose significant diagnostic and management challenges. This study aims to compare septic and aseptic RHA cases in terms of inflammatory markers, prevalence of diabetes mellitus (DM), surgical time, blood transfusion requirements, soft tissue thickness, and mortality rates. MATERIAL AND METHODS This retrospective study included 49 patients who underwent RHA between 2015 and 2020. Patients were divided into aseptic (n=34) and septic (n=15) groups. Demographic characteristics, comorbidities, preoperative erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, soft tissue thickness, and revision surgery time were compared. RESULTS ESR and CRP levels were significantly higher in the septic group (p=0.002, p=0.001), soft tissue thickness was lower (p=0.003), blood transfusion requirements (p<0.001) and surgical times (p<0.00001) were higher, while no significant difference was found in mortality rates between the groups (p=0.576). CONCLUSIONS This study examined septic and aseptic loosening in revision hip arthroplasty, finding higher inflammatory markers, increased transfusion needs, longer operative times, and greater infection risk with diabetes in septic cases. In our study, soft tissue thickness was found to be lower in infected cases, unlike the literature. While previous studies suggested that soft tissue thickness was the cause of infection, our study indicates that the decrease in skin thickness is a consequence of infection.