Urinary tract infections in patients undergoing orthopaedic procedures: A contemporary review (2021-2026)

Urinary tract infections are one of the most frequent healthcare-associated infections representing a relevant postoperative complication in orthopedics patients. These infections are associated with increased morbidity, prolonged hospitalizations, and higher rates of readmission. In selected settings, they may coexist with or precede surgical site infections, including periprosthetic joint infections. This review aims to summarize and evaluate recent evidence from the last five years in regards to epidemiology, risk factors, clinical consequences, and preventative strategies for patients undergoing orthopaedic interventions. A narrative literature review was conducted using the PubMed/MEDLINE database utilizing English-language publications from January 2021 to February 2026. Particular emphasis was placed on systematic reviews, meta-analyses, cohort studies, and large database analyses related to hip fracture surgery, total joint arthroplasty, and spine surgery. These studies indicate that urinary tract infections remain particularly common among the geriatric population undergoing hip fracture surgery. Major modifiable risk factors include urinary catheterization and postoperative urinary retention. Symptomatic urinary tract infections briefly prior to surgery are associated with an increased risk of postoperative complications compared to asymptomatic bacteriuria. Avoidance of unnecessary urinary catheterization and routine urine testing in asymptomatic patients reduces the use of unnecessary antibiotics while preserving surgical outcomes. Urinary tract infections continue to represent a significant clinical issue in orthopaedic patients. Evidence supports catheter stewardship, targeted diagnostic strategies, and integrated preventive approaches to reduce infection-related complications.