Presence of Medical Comorbidities in Patients With Infected Primary Hip or Knee Arthroplasties

Lai, Kafai; Bohm, Éric; Burnell, Colin; Hedden, David R.

doi:10.1016/j.arth.2006.09.002

Cited by 150 publications

(107 citation statements)

References 27 publications

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“…Prosthetic infection rates between 5.5 and 7% in diabetic patients undergoing TKA have been recorded [9,13,26]. However, we also noted there were no prosthetic infections in patients with DM who had a BMI less than 30 kg/m 2 .…”

Section: Discussionsupporting

confidence: 48%

Obese Diabetic Patients are at Substantial Risk for Deep Infection after Primary TKA

Dowsey

Choong

2008

Clin Orthop Relat Res

225

138

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We conducted a prospective study of 1214 consecutive primary TKAs to compare the deep prosthetic infection rate between obese and nonobese patients during the first 12 months after surgery. We also sought to determine whether patient or surgical variables such as comorbidities, age, gender, blood transfusion, use of surgical drains, and antibiotic-impregnated cement were predictors of subsequent prosthetic infection after primary TKA. The overall prosthetic infection rate was 1.5% (n = 18). The odds for a deep prosthetic infection were greater in patients with morbid obesity (odds ratio [OR], 8.96; 95% confidence interval, 1.59-50.63) and diabetes (OR, 6.87; 95% confidence interval, 2.42-19.56). Men were more likely to have a prosthetic infection develop than women (OR, 5.93; 95% confidence interval, 1.95-18.04) and the prosthetic infection rate was lower (OR, 0.24; 95% confidence interval, 0.06-0.95) in patients when a surgical drain was used. There were no prosthetic infections in patients with diabetes who were not obese.This compares with 11 prosthetic infections in patients who were obese and diabetic and four prosthetic infections in patients who were obese but not diabetic. Morbid obesity and obesity combined with diabetes are risk factors for periprosthetic infection after TKA.

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Section: Discussionsupporting

confidence: 48%

Obese Diabetic Patients are at Substantial Risk for Deep Infection after Primary TKA

Dowsey

Choong

2008

Clin Orthop Relat Res

225

138

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“…An American Society of Anesthesiologists score of greater than 2, uncontrolled diabetes, and rheumatoid arthritis, for example, can significantly increase the risk of PJI (18,20,(23)(24)(25). Furthermore, any other comorbidity accompanied by diabetes is shown to place patients at a cumulatively higher risk for infection (21,26).…”

Section: Medical Optimization Of Hostmentioning

confidence: 99%

Prevention of Periprosthetic Joint Infection

Rezapoor

Parvızı

2015

The Journal of Arthroplasty

121

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“…Periprosthetic joint infections have known modifiable and nonmodifiable risk factors [12]. Established modifiable risk factors include allogenic blood transfusion, excessive anticoagulation treatment, obesity, malnutrition, simultaneous bilateral surgery, alcoholism, use of surgical drain and long postoperative urinary catheterisation [12][13][14][15][16]. Interventions to prevent or correct these modifiable risk factors have the potential to lower the periprosthetic joint infection rate.…”

Section: Introductionmentioning

confidence: 99%

Is there an association between periprosthetic joint infection and low vitamin D levels?

Maier

Horas

Seeger

et al. 2014

International Orthopaedics (SICOT)

103

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Purpose Vitamin D is increasingly being recognized as an important mediator of immune function and may have a preventive role in the pathogenesis of periprosthetic joint infection. To the best of our knowledge, no other study has examined possible associations between periprosthetic joint infection and vitamin D deficiency. We investigated the rate of vitamin D deficiency in patients treated for periprosthetic joint infection and whether vitamin D deficiency is independent of other risk factors for vitamin D deficiency in patients with periprosthetic joint infection. Methods Serum 25-hydroxyvitamin D (25OHD) levels of every patient scheduled to receive a total prosthesis either of the hip, knee, or shoulder in the orthopaedic department of the Johannes-Guttenberg-University Hospital in Mainz, Germany (109 patients), were measured after admission. Furthermore, serum 25OHD levels were measured for every patient presenting with periprosthetic joint infection (n=50) or aseptic loosening of the prosthesis (n=31) scheduled to undergo revision surgery. The prevalence of normal (>30 ng/ml), insufficient (20-30 ng/ml), and deficient (<20 ng/ml) 25OHD levels was determined. Results All tested patient subgroups showed low vitamin D levels. Statistical analysis found no significant difference in vitamin D levels comparing patients with prosthesis and patients with aseptic prosthesis loosening (p=0.58). Significant differences in 25OHD levels were found comparing patients with periprosthetic joint infection and patients scheduled for primary arthroplasty (p<0.001). In addition, we found a significant difference (p<0,001) in 25OHD levels of patients with periprosthetic joint infection compared with patients with aseptic prosthesis loosening. Conclusion We found a high frequency of vitamin D deficiency in patients being treated by primary arthroplasty and those with aseptic joint prosthetic loosening and periprosthetic joint infection. Vitamin D deficiency was severe in patients with periprosthetic joint infection.

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Presence of Medical Comorbidities in Patients With Infected Primary Hip or Knee Arthroplasties

Cited by 150 publications

References 27 publications

Obese Diabetic Patients are at Substantial Risk for Deep Infection after Primary TKA

Obese Diabetic Patients are at Substantial Risk for Deep Infection after Primary TKA

Prevention of Periprosthetic Joint Infection

Is there an association between periprosthetic joint infection and low vitamin D levels?

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