Deep-wound infection after total hip replacement under contemporary aseptic conditions.

Schutzer, Steven F.; Wh, Harris

doi:10.2106/00004623-198870050-00013

Cited by 115 publications

(51 citation statements)

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“…The rate of joint infections in our patients is 0.29%. In the literature, the rates of joint infection range from 0.38% to 2.3% [28,35,39]. These data suggest treated UTI is a minimal risk factor for prosthetic joint infection.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

Koulouvaris¹,

Sculco²,

Finerty³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Surgical wound infection is a serious and potentially catastrophic complication after joint arthroplasty. Urinary tract infection is a common infection that creates a potential reservoir of resistant pathogens and increases patient morbidity. We asked whether treated preoperative and postoperative urinary tract infections are risk factors for deep joint infection. We examined the medical records of 19,735 patients. The minimum had joint infections develop. Of these, three had preoperative and four had postoperative urinary tract infections. The majority of bacteria were not enteric. The bacteria in the two types of infections were not identical. Control subjects were randomly selected from a list of patients matched with patients having infections. Of these, eight had preoperative and one had postoperative urinary tract infections. We found no association between the preoperative urinary tract infection (odds ratio, 0.341; 95% confidence interval, 0.086-1.357) or postoperative urinary tract infection (odds ratio, 4.222; 95% confidence interval, 0.457-38.9) and wound infection. Only one of the 58 patients with wound infections had a urinary tract infection with the same bacteria in both infections. Given the infection rate was very low (0.29%), the power of the study was only 25%. Although limited, the data suggest patients with urinary tract infections had no more likelihood of postoperative infection. We believe treated urinary tract infection should not be a reason to delay or postpone surgery. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

Koulouvaris¹,

Sculco²,

Finerty³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…Various prophylactic measures including improved patient selection (eg, elimination of remote infections), routine use of prophylactic antibiotics, use of laminar airflow, use of body exhaust suits, minimized activity in the operating room, and use of antibiotic impregnated bone cement have helped reduce the deep infection rate after primary THA from the historical 11% to less than 1% [12,13,53,54,56]. Currently reported deep infection rates after primary TKA are approximately 1% to 2% [14,48].…”

Section: Introductionmentioning

confidence: 99%

Is There a Role for Tissue Biopsy in the Diagnosis of Periprosthetic Infection?

Meermans

Haddad

2010

Clinical Orthopaedics &Amp; Related Research

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Background Successful treatment of an infected joint arthroplasty depends on correctly identifying the responsible pathogens. The value of a preoperative biopsy remains controversial. Questions/purposes We (1) compared the sensitivity and specificity of both tests separately and in combination, and (2) asked whether the combination of tissue biopsy and aspiration would improve our diagnostic yield in the evaluation of periprosthetic joint infections. Patients and Methods We prospectively followed 120 patients with suspected infection of a total joint arthroplasty: 64 with THAs and 56 with TKAs. All patients had aspiration with culture and biopsy. Results The sensitivity was 83% for aspiration, 79% for biopsy, and 90% for the combination of both techniques. The specificity was 100% for aspiration and biopsy and the combination. The overall accuracy was 84%, 81%, and 90%, respectively.

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“…Generally, the use of a bone graft in association with one-stage revision arthroplasty is not recommended because the risk of infection is increased by the bone graft [23]. However, one report concluded that the use of allografts is not associated with an increased rate of failure of one-stage revision of infected hip replacements [16].…”

Section: Discussionmentioning

confidence: 99%

One-stage cementless revision arthroplasty for infected hip replacements

Yoo

Koo

Yoon

et al. 2008

International Orthopaedics (SICOT)

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We hypothesised that one-stage cementless revision hip arthroplasty may have advantages and a role in the treatment of selected patients with an infected hip replacement. We retrospectively reviewed all patients with an infected hip replacement treated with one-stage revision using cementless implants. Twelve patients were reviewed and followed up for at least three years (average: 7.2 years, range: 3.3-11.3 years) postoperatively. One recurrence of infection and one aseptic stem loosening were detected during followup. Grafted bone, which was used in eight patients, appeared to have united to host bone in all patients. The success rate of treatment was 83.3% when infection recurrence or component loosening were regarded as failure. One-stage revision hip arthroplasty using cementless implants appears to have a role in the treatment of carefully selected patients with an infected hip replacement if meticulous débridement is performed and appropriate antibiotics are properly used.Résumé Notre hypothèse de travail était la suivante: le changement en un temps par une prothèse sans ciment d'une prothèse totale de hanche infectée, est la bonne indication thérapeutique. Matériel et méthode: nous avons revu de façon rétrospective tous les patients présentant une hanche infectée traitée par une révision en un temps en utilisant un implant sans ciment. 12 patients ont été revus et suivis pendant au moins 3 ans (7,2 ans en moyenne, 3,3 et 11,3 ans postopératoire). Résultats: nous avons observé une récidive d'infection et un descellement aseptique durant cette période de suivi. L'os greffé chez 8 patients nous apparaît comme ayant consolidé à l'os hôte chez tous les patients. Le pourcentage de succès thérapeutique est de 83,3% si l'on regarde la récurrence de l'infection ou le descellement aseptique. En conclusion: les révisions en un temps en utilisant un implant sans ciment nous apparaissent comme un traitement de choix chez les patients sélectionnés avec soin et présentant une infection de prothèse totale de hanche.

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Deep-wound infection after total hip replacement under contemporary aseptic conditions.

Cited by 115 publications

References 0 publications

Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

Is There a Role for Tissue Biopsy in the Diagnosis of Periprosthetic Infection?

One-stage cementless revision arthroplasty for infected hip replacements

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