The impact of patient and surgical factors on the rate of infection after primary total knee arthroplasty
| Autor: | Edward R. Tayton, Simon W. Young, Chris Frampton, Gary J. Hooper |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Prosthesis-Related Infections Multivariate analysis Databases Factual medicine.medical_treatment Total knee arthroplasty Osteotomy 03 medical and health sciences 0302 clinical medicine Risk Factors Informed consent medicine Humans Orthopedics and Sports Medicine Registries 030212 general & internal medicine Prosthesis-Related Infection Arthroplasty Replacement Knee Aged 030222 orthopedics business.industry Odds ratio Middle Aged Arthroplasty Confidence interval Anti-Bacterial Agents Prosthesis Failure Surgery Female Knee Prosthesis business New Zealand |
| Zdroj: | The Bone & Joint Journal. :334-340 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.98b3.36775 |
| Popis: | Aims The aim of this study was to identify risk factors for prosthetic joint infection (PJI) following total knee arthroplasty (TKA). Patients and Methods The New Zealand Joint Registry database was analysed, using revision surgery for PJI at six and 12 months after surgery as primary outcome measures. Statistical associations between revision for infection, with common and definable surgical and patient factors were tested. Results A total of 64 566 primary TKAs have been recorded on the registry between 1999 and 2012 with minimum follow-up of 12 months. Multivariate analysis showed statistically significant associations with revision for PJI between male gender (odds ratio (OR) 1.85, 95% confidence interval (CI) 1.24 to 2.74), previous surgery (osteotomy (OR 2.45 95% CI 1.2 to 5.03), ligament reconstruction (OR 1.85, 95% CI 0.68 to 5.00)), the use of laminar flow (OR 1.6, 95% CI 1.04 to 2.47) and the use of antibiotic-laden cement (OR 1.93, 95% CI 1.19 to 3.13). There was a trend towards significance (p = 0.052) with the use of surgical helmet systems at six months (OR 1.53, 95% CI 1.00 to 2.34). Conclusion These findings show that patient factors remain the most important in terms of predicting early PJI following TKA. Furthermore, we found no evidence that modern surgical helmet systems reduce the risk of PJI and laminar flow systems may actually increase risk in TKA. The use of this registry data assists the estimation of the risk of PJI for individual patients, which is important for both informed consent and the interpretation of infection rates at different institutions. Take home message: Infection rates in TKA are related to both individual patient and surgical factors, and some modern methods of reducing infection may actually increase infection risk. Cite this article: Bone Joint J 2016;98-B:334–40. |
| Databáze: | OpenAIRE |
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