Infection burden in total hip and knee arthroplasties: an international registry-based perspective

Springer, Bryan D.; Cahue, September; Etkin, Caryn D.; Lewallen, David G.; McGrory, Brian J.

doi:10.1016/j.artd.2017.05.003

Cited by 216 publications

(130 citation statements)

References 23 publications

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“…We attribute our low overall infection rate to a disci-plined comprehensive TJA protocol focusing on minimizing SSI and PJI. Our selection of the GT dressing for postoperative application did not appear to adversely affect our rates of SSI and PJI when compared to other published series [20]. Our low PJI rate is encouraging in light of our series having 49% B and C grade systemic hosts.…”

Section: Discussionsupporting

confidence: 59%

Bio-Occlusive Gauze with Tegaderm: A Dressing for Surgical Wounds in Primary THA and TKA

2018

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Background: We introduce a simple, cost-effective bioocclusive dressing to be used for primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA).Methods: The gauze-Tegaderm™ (GT) dressing consists of a 5cm wide 8-layered gauze covered by 3 to 5 mediumsized Tegaderm transparent films. We prospectively evaluated 100 consecutive primary THA's and 107 consecutive primary TKA's utilizing this dressing with a minimum of one-year follow-up.Results: In the primary THA group, there was one surgical site infection (SSI) requiring oral antibiotic treatment. There were no cases of periprosthetic joint infection (PJI). In the primary TKA group, there were two surgical site infections requiring oral antibiotic treatment and one case of chronic PJI requiring a two-stage exchange protocol. Discussion: Our SSI and PJI rates are comparable to published rates in the literature. The GT dressing is a simple, inexpensive dressing that can compete against the many proprietary bio-occlusive dressings that are more expensive and are not readily available worldwide. Our favorable review has merited a large volume randomized controlled study comparing the GT dressing to another proprietary bioocclusive dressing.

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Section: Discussionsupporting

confidence: 59%

Bio-Occlusive Gauze with Tegaderm: A Dressing for Surgical Wounds in Primary THA and TKA

2018

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“…We found that at tropical sites, patients with positive swabs following surgery were more likely to be younger, male, had undergone knee surgery and have had primary procedures. Age and gender have been well described in the literature as risk factors for infection following orthopaedic surgery, and it is also known from national joint replacement registry data that knee replacements pose a higher risk than for hips [27][28][29][30]. We note that both subtropical sites included in our study are located within the same metropolitan city, while the four tropical sites are regional and remote with substantially lower population densities.…”

Section: Discussionmentioning

confidence: 60%

Bacterial Profile, Multi-Drug Resistance and Seasonality Following Lower Limb Orthopaedic Surgery in Tropical and Subtropical Australian Hospitals: An Epidemiological Cohort Study

Vickers

Ballard

Harris

et al. 2020

IJERPH

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We aimed to describe the epidemiology, multi-drug resistance and seasonal distribution of bacteria cultured within 12 months following lower limb orthopaedic surgery in tropical and subtropical Australian hospitals between 2010 and 2017. We collected data from four tropical and two subtropical hospitals. Categorical variables were examined using the Pearson Chi-squared test or Fisher’s Exact test, and continuous variables with the Student t-test or Mann–Whitney U test. A Poisson regression model was used to examine the relationship between season, weather and the incidence of Staphylococcus and nonfermentative species. We found that at tropical sites, nonfermenters (Pseudomonas aeruginosa and Acinetobacter baumannii) were more common (28.7% vs. 21.6%, p = 0.018), and patients were more likely to culture multi-drug-resistant (MDR) nonfermenters (11.4% vs. 1.3%, p = 0.009) and MDR Staphylococcus aureus (35.9% vs. 24.6%, p = 0.006). At tropical sites, patients were more likely to be younger (65.9 years vs. 72.0, p = < 0.001), male (57.7% vs. 47.8%, p = 0.005), having knee surgery (45.3% vs. 34.5%, p = 0.002) and undergoing primary procedures (85.0% vs. 73.0%, p = < 0.001). Species were similar between seasons in both tropical and subtropical hospitals. Overall, we found that following lower limb orthopaedic surgery in tropical compared with subtropical Australia, patients were more likely to culture nonfermenters and some MDR species.

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“…These medications leave transplant patients vulnerable to wound complications and infection, with several previous studies finding increased rates of prosthetic joint infections in solid organ transplant recipients . The reported rate of infection for THA in a general patient population in current literature is around 1% . In this cohort of transplant patients, four of 17 (23.5%) suffered post‐operative infections, with three superficial infections (17.6%), and one deep joint infection (5.9%) requiring surgical management.…”

Section: Discussionmentioning

confidence: 74%

Outcomes of total hip arthroplasty surgery in heart and lung transplant recipients

Cosic

Kimmel

Valsalan

et al. 2019

ANZ Journal of Surgery

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Background: Traditionally, arthroplasty in heart and lung transplant patients has been undertaken to manage transplant-related complications. More recently, arthroplasty is increasingly being performed for end-stage osteoarthritis. This study reviewed short-term outcomes and complications of total hip arthroplasty (THA) in heart and lung transplant recipients. Methods: A retrospective cohort of heart and lung transplant recipients who underwent THA was identified using ICD-10 coding. Post-operative complications and hospital outcomes were collected using the patient medical record. Results: Thirteen patients underwent 17 primary THA between 2008 and 2017, including five for osteoarthritis and 12 for femoral head avascular necrosis. Of the 13 patients, nine were bilateral sequential lung transplant recipients and four were orthotopic heart transplant recipients. The mean patient age was 61 years, with nine being male. Overall, five patients had one post-operative complication with eight having two or more complications. Surgical complications included three intraoperative fractures, three patients with superficial infection and one with deep infection requiring surgery. Seven patients had significant bleeding requiring blood transfusion. Prosthetic dislocations occurred in two patients, with one patient requiring revision surgery (developing a joint infection). Other complications included one pulmonary embolism, two episodes of pneumonia and six episodes of acute kidney injury, whilst three patients developed post-operative delirium. At 6-week follow-up, five patients had ongoing pain and seven had limitations with mobility. At 12-month follow-up, three patients reported ongoing pain. Conclusion: Complications following THA after transplant are common. The risks and benefits of THA should be carefully considered preoperatively in this cohort.

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Infection burden in total hip and knee arthroplasties: an international registry-based perspective

Cited by 216 publications

References 23 publications

Bio-Occlusive Gauze with Tegaderm: A Dressing for Surgical Wounds in Primary THA and TKA

Bio-Occlusive Gauze with Tegaderm: A Dressing for Surgical Wounds in Primary THA and TKA

Bacterial Profile, Multi-Drug Resistance and Seasonality Following Lower Limb Orthopaedic Surgery in Tropical and Subtropical Australian Hospitals: An Epidemiological Cohort Study

Outcomes of total hip arthroplasty surgery in heart and lung transplant recipients

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