Periprosthetic Knee and Hip Infection — Is It Possible to Compare Treatment Outcomes?

Abstract

Background. It is known that the outcomes of patients treatment with periprosthetic joint infection (PJI) are significantly influenced by the state of the patient's body, the nature of the pathogen, the state of tissues in the area of the infectious focus and the treatment tactics. However, topographic and anatomical features of the blood supply to the knee and hip joints, as well as the volume of soft tissues, can affect the spectrum of pathogens, manifestations of the infectious process and, as a consequence, the effectiveness of treatment.
 The purpose of the study was to conduct a comparative analysis of the somatic status of patients, the etiology of the infectious process and the effectiveness of treatment of PJI depending on its localization.
 Materials and methods: a single-center retrospective study was conducted. The cases of 337 patients were studied – 119 patients with knee and 218 patients with hip PJI who underwent treatment with a two-stage technique during the period from 2007 to 2017. A comparative analysis of the PJI pathogens structure and concomitant pathology between patients with hip and knee PJI was carried out. The frequency of infection relief in the groups was counted.
 Results: Recurrence of PJI was diagnosed 4 times more often in patients with hip PJI relative to knee PJI. Risk factors for relapse were Gram (-) pathogens, microbial associations and fistulous forms of the infectious process. The fistula form is associated with a significantly larger volume of blood loss at the background of a longer operation at the sanitizing stage.
 Conclusion: the infectious process in the hip area is more likely to develop relapse relative to the knee. Further analysis of relapse promotion critical factors is needed in order to affect them.