Single-Dose Perioperative Antibiotics Do Not Increase the Risk of Surgical Site Infection in Unicompartmental Knee Arthroplasty

Wyles, Cody C.; Vargas-Hernández, Juan S.; Carlson, Samuel; Carlson, Bayard C.; Sierra, Rafael J.

doi:10.1016/j.arth.2019.02.041

Cited by 14 publications

(14 citation statements)

References 20 publications

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“…[ 55 ] retrospectively reviewed 6,080 patients and revealed that single-dose of prophylactic antibiotics was not associated with increased acute PJI and short-term complications, compared to a 24-h antibiotic regimen. Some surgeons reported similar results [ 56 , 57 ]. Patient-reported allergy to penicillin was most likely to be prescribed with clindamycin (1.1 vs. 80.7%; P < 0.05) or vancomycin (4.0 vs. 12.4%; P < 0.05) rather than cefazolin (94.9 vs. 6.9%; P < 0.05) [ 58 ].…”

Section: Introductionmentioning

confidence: 69%

Risk factors associated with surgical site infections following joint replacement surgery: a narrative review

Zhang

Chan

et al. 2022

Arthroplasty

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Background Surgical site infection following joint replacement surgery is still a significant complication, resulting in repeated surgery, prolonged antibiotic therapy, extended postoperative hospital stay, periprosthetic joint infection, and increased morbidity and mortality. This review discusses the risk factors associated with surgical site infection. Related risk factors The patient-related factors include sex, age, body mass index (BMI), obesity, nutritional status, comorbidities, primary diagnosis, living habits, and scores of the American Society of Anesthesiologists physical status classification system, etc. Surgery-related factors involve preoperative skin preparation, prolonged duration of surgery, one-stage bilateral joint replacement surgery, blood loss, glove changes, anti-microbial prophylaxis, topical anti-bacterial preparations, wound management, postoperative hematoma, etc. Those risk factors are detailed in the review. Conclusion Preventive measures must be taken from multiple perspectives to reduce the incidence of surgical site infection after joint replacement surgery.

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Section: Introductionmentioning

confidence: 69%

Risk factors associated with surgical site infections following joint replacement surgery: a narrative review

Zhang

Chan

et al. 2022

Arthroplasty

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“…However, no studies to the authors’ knowledge directly compare the incidence of UKA and TKA PJI in the US population. Reported rates of UKA and TKA PJI vary significantly depending on the institution and patient population, ranging from 0% to 2.5% [ 4 , [18] , [19] , [20] , [21] , [22] , [23] , 27 , [28] , [29] , [30] ] at early time points. Lum et al.…”

Section: Discussionmentioning

confidence: 99%

“…[ 28 ] reported a 2.2% rate of UKA PJI in patients with a BMI > 40 kg/m 2 at a mean follow-up of 3.4 years. While the reported rates of PJI vary, most US cohort studies report the rate of UKA PJI from 0.5% to 1% [ 4 , 27 , [28] , [29] , [30] ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, UKA has been touted to have a lower rate of deep periprosthetic joint infection (PJI) than TKAs, although recent data show that treatment of UKA PJIs does not have better outcomes than TKA PJI treatment [ 25 , 26 ]. However, owing to the low incidence of UKA compared with TKA [ 10 , 11 ], the relatively low incidence of deep PJI in both UKA and TKA, and selection bias of younger and healthier patients toward UKA [ [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] ], there is a paucity of adequately powered data comparing UKA and TKA PJI rates in similar patient populations.…”

Section: Introductionmentioning

confidence: 99%

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Unicompartmental Knee Arthroplasty Is Associated With a Lower Rate of Periprosthetic Joint Infection Compared to Total Knee Arthroplasty

Lee

Cross

et al. 2021

Arthroplasty Today

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Background: Several studies have reported lower perioperative complications with unicompartmental knee arthroplasty (UKA) than with total knee arthroplasty (TKA). However, there is a paucity of data analyzing the incidence of periprosthetic joint infection (PJI) in similar patients undergoing UKA and TKA. As such, we sought to analyze the incidence of UKA and TKA PJI in a large matched population. Material and Methods: The Mariner data set of the PearlDiver database was queried for all patients undergoing UKA or TKA during 2010-2017. Included patients were required to have at least 2 years of database inclusion after surgery. Patients were then matched at a 1:3 ratio (UKA:TKA) on age, gender, Elixhauser Comorbidity Index, tobacco use, and obesity. Rates of PJI requiring operative intervention within 90 days and 1 year were calculated. Results: In total, 5636 patients having undergone UKA were matched to 16,890 patients having undergone TKA. Fifteen (0.27%) after UKA and 79 (0.47%) after TKA had a PJI surgically managed within 90 days (risk ratio ¼ 0.57, 95% confidence interval ¼ 0.33-0.99, P ¼ .04). Thirty (0.53%) after UKA and 136 (0.81%) after TKA had a PJI surgically managed within 1 year (risk ratio ¼ 0.66, 95% confidence interval ¼ 0.45-0.98, P ¼ .04). Conclusions: In a large group of rigorously matched patients, UKA was associated with a significantly lower rate of surgically managed PJI than TKA at 90 days and 1 year; however, the rate of PJI in both groups remained low at <1% at 90 days and 1 year.

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“…Because of not increasing postoperative complications and risk of re-admission, outpatient joint arthroplasty have been widely performed in recent years [17]. A shorter LOS could effectively save the cost of hospitalization and reduce the risk of nosocomial infection [18]. Current studies have con rmed the safety and e cacy of outpatient UKA [7][9] [13].…”

Section: Discussionmentioning

confidence: 99%

Spinal Versus General Anesthesia for the Outpatient Unicompartmental Knee Arthroplasty: A Randomized Controlled Trial

Chen¹,

Yin²,

Xu³

et al. 2020

Preprint

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Purpose: To compare the early clinical outcomes between anesthetic techniques in outpatient unicompartmental knee arthroplasty (UKA) and investigate factors responsible for delayed discharge. Method: A randomized controlled trial was conducted on 64 consecutive and unselected patients who underwent primary, medial UKA and randomly divided into two groups:32 patients with spinal anaesthesia(Group A) and 32 with general anaesthesia(Group B). There were no significant differences in gender, age, body mass index (BMI), the hospital for Special Surgery knee score (HSS), and American Society of Anesthesiology(ASA) class between the two groups (P >0.05).Results：Totally 64 patients were involved, including 20 males and 42 females, with an average age of 60.4 ± 3.8 year-old. The length of stay(LOS) and total expense were significantly less in group A than those in group B (P < 0.05). There was no significant difference between two groups on the discharge day and the reasons for not discharge(P>0.05). Lack of mobilization (84%), pain (23%), and PONV (17%) were main reasons for patients not meeting the discharge criteria on DOS (Table 2). Patients with spinal anaesthesia underwent a longer surgery time than those with GA.(P<0.05); Patients in the Group A had a significantly earlier oral fluid intake and walking unaided(P<0.05); Pain occurred significantly earlier in Group B(P<0.05). Conclusion: In patients who underwent outpatient UKA, spinal anaesthesia is significantly superior to general anaesthesia with shorter discharge time and lower cost. With strict patient selection and safe anaesthesia, outpatient UKA could attain a good clinical outcome with both anaesthesia techniques.

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Single-Dose Perioperative Antibiotics Do Not Increase the Risk of Surgical Site Infection in Unicompartmental Knee Arthroplasty

Cited by 14 publications

References 20 publications

Risk factors associated with surgical site infections following joint replacement surgery: a narrative review

Risk factors associated with surgical site infections following joint replacement surgery: a narrative review

Unicompartmental Knee Arthroplasty Is Associated With a Lower Rate of Periprosthetic Joint Infection Compared to Total Knee Arthroplasty

Spinal Versus General Anesthesia for the Outpatient Unicompartmental Knee Arthroplasty: A Randomized Controlled Trial

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