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Risk factors for prosthetic joint infection: case-control study

E F Berbari1, A D Hanssen, M C Duffy

  • 1Department of Orthopedics, Mayo Clinic, Rochester, Minnesota, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|November 25, 1998
PubMed
Summary

Surgical site infections, higher National Nosocomial Infections Surveillance risk scores, malignancy, and prior joint arthroplasty increase prosthetic joint infection risk. These factors are crucial for preventing joint replacement infections.

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Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Epidemiology

Background:

  • Prosthetic joint infections (PJIs) are serious complications following total hip or knee arthroplasty.
  • Identifying risk factors is crucial for effective prevention strategies.

Purpose of the Study:

  • To determine risk factors associated with the development of prosthetic joint infection.
  • To inform clinical practice and improve patient outcomes after joint arthroplasty.

Main Methods:

  • A matched case-control study design was employed.
  • Cases were patients with prosthetic hip or knee joint infection.
  • Controls were patients who underwent arthroplasty without infection.

Main Results:

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  • Surgical site infections not involving the prosthesis significantly increased PJI risk (OR, 35.9).
  • Higher National Nosocomial Infections Surveillance (NNIS) System surgical patient risk index scores (1 or 2) were associated with increased PJI risk (ORs, 1.7 and 3.9, respectively).
  • Malignancy (OR, 3.1) and a history of joint arthroplasty (OR, 2.0) were also identified as significant risk factors.

    • Conclusions:

    • Surgical site infections, NNIS risk index scores of 1 or 2, malignancy, and prior joint arthroplasty are associated with an increased risk of prosthetic joint infection.
    • These findings highlight key areas for targeted interventions to reduce PJI incidence.