Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta-analysis.

Lingde Kong, Junming Cao, Yingze Zhang, Wenyuan Ding, Yong Shen
Author Information
  1. Lingde Kong: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Hebei, P.R. China.
  2. Junming Cao: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Hebei, P.R. China.
  3. Yingze Zhang: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Hebei, P.R. China.
  4. Wenyuan Ding: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Hebei, P.R. China.
  5. Yong Shen: Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Hebei, P.R. China.

Abstract

To identify risk factors for periprosthetic joint infection following primary total joint arthroplasty, a systematic search was performed in Pubmed, Embase and Cochrane library databases. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Patient characteristics, surgical-related factors and comorbidities, as potential risk factors, were investigated. The main factors associated with infection after total joint arthroplasty (TJA) were male gender (OR, 1·48; 95% CI, 1.19-1.85), age (SMD, -0·10; 95% CI, -0.17--0.03), obesity (OR, 1·54; 95% CI, 1·25-1·90), alcohol abuse (OR, 1·88; 95% CI, 1·32-2·68), American Society of Anesthesiologists (ASA) scale > 2 (OR, 2·06; 95% CI, 1·77-2·39), operative time (SMD, 0·49; 95% CI, 0·19-0·78), drain usage (OR, 0·36; 95% CI, 0·18-0·74), diabetes mellitus (OR, 1·58; 95% CI, 1·37-1·81), urinary tract infection (OR, 1·53; 95% CI, 1.09-2.16) and rheumatoid arthritis (OR, 1·57; 95% CI, 1·30-1·88). Among these risk factors, ASA score > 2 was a high risk factor, and drain usage was a protective factor. There was positive evidence for some factors that could be used to prevent the onset of infection after TJA.

Keywords

References

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MeSH Term

Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip
Arthroplasty, Replacement, Knee
Female
Humans
Male
Middle Aged
Osteoarthritis
Prosthesis-Related Infections
Reoperation
Risk Factors

Word Cloud

Created with Highcharts 10.0.095%CIORfactorsjointinfectionrisktotalarthroplastyfactorperiprostheticfollowingprimaryTJA1SMDASAdrainusageRiskidentifysystematicsearchperformedPubmedEmbaseCochranelibrarydatabasesPooledoddsratiosORsstandardisedmeandifferencesSMDsconfidenceintervalsCIscalculatedPatientcharacteristicssurgical-relatedcomorbiditiespotentialinvestigatedmainassociatedmalegender1·4819-185age-0·10-017--003obesity1·541·25-1·90alcoholabuse1·881·32-2·68AmericanSocietyAnesthesiologistsscale > 22·061·77-2·39operativetime0·490·19-0·780·360·18-0·74diabetesmellitus1·581·37-1·81urinarytract1·5309-216rheumatoidarthritis1·571·30-1·88Amongscore > 2highprotectivepositiveevidenceusedpreventonsethipkneearthroplasty:meta-analysisMeta-analysisPeriprostheticSystematicreviewTotal

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