The Risk of a Deep Infection Associated With Intraarticular Injections Before a Total Knee Arthroplasty

Amin, Nirav H.; Omiyi, Didi E.; Kuczynski, Bozena; Cushner, Fred D.; Scuderi, Giles R.

doi:10.1016/j.arth.2015.08.001

Cited by 34 publications

(44 citation statements)

References 15 publications

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“…The publication year of the 24 studies ranged from 1998 to 2016. According to the NOS score, 9 studies scored 8 (9,17,19,22,23,25,27,32,34), 11 studies scored 7 (15,16,18,24,26,(28)(29)(30)33,35,36) and 4 studies scored 6 (14,20,21,31). All studies were of high quality.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta‐analysis

Kong

Cao

Zhang

et al. 2016

International Wound Journal

179

139

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To identify risk factors for periprosthetic joint infection following primary total joint arthroplasty, a systematic search was performed in Pubmed, Embase and Cochrane library databases. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Patient characteristics, surgical-related factors and comorbidities, as potential risk factors, were investigated. The main factors associated with infection after total joint arthroplasty (TJA) were male gender (OR, 1·48; 95% CI, 1.19-1.85), age (SMD, -0·10; 95% CI, -0.17--0.03), obesity (OR, 1·54; 95% CI, 1·25-1·90), alcohol abuse (OR, 1·88; 95% CI, 1·32-2·68), American Society of Anesthesiologists (ASA) scale > 2 (OR, 2·06; 95% CI, 1·77-2·39), operative time (SMD, 0·49; 95% CI, 0·19-0·78), drain usage (OR, 0·36; 95% CI, 0·18-0·74), diabetes mellitus (OR, 1·58; 95% CI, 1·37-1·81), urinary tract infection (OR, 1·53; 95% CI, 1.09-2.16) and rheumatoid arthritis (OR, 1·57; 95% CI, 1·30-1·88). Among these risk factors, ASA score > 2 was a high risk factor, and drain usage was a protective factor. There was positive evidence for some factors that could be used to prevent the onset of infection after TJA.

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Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta‐analysis

Kong

Cao

Zhang

et al. 2016

International Wound Journal

179

139

View full text Add to dashboard Cite

show abstract

“…Some of the variables that have been shown to affect the outcome after total joint replacement include social and demographic characteristics, medical comorbidities, and surgical technique [3][4][5][6][7]. Areas of continued active research include the effect of intrinsic factors such as obesity [8][9][10], cardiovascular disease [11,12], mental health disorders [13•, 14-17•, 18•, 19], hepatic disease [20, 21•, 22, 23•, 24], nutritional deficiencies [25-29•, 30], bone metabolic disease [31][32][33][34][35][36][37], and diabetes mellitus [38•, 39, 40], as well as external factors such as nicotine use [41,42], recent corticosteroid injections [43][44][45][46][47], and discharge disposition [48,49]. The goal of this article is to review the most recent literature, published within the last 3 years, regarding a selection of patient-specific factors that may influence This article is part of the Topical Collection on Quality and Cost Control in TJA outcomes following total joint arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

Factors That Affect Outcome Following Total Joint Arthroplasty: a Review of the Recent Literature

Schwartz

Lange

2017

Curr Rev Musculoskelet Med

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Purpose of Review It is well established that certain patientspecific risk factors affect outcomes following total joint arthroplasty. The goal of this paper is to summarize the latest data on several variables that have been investigated in the last 3 years and to characterize the effects these factors have on the success of hip and knee replacement. Recent Findings Preoperative diagnoses of depression and anxiety, liver disease, hypoalbuminemia, vitamin D deficiency, and diabetes mellitus are associated with increased risk of postoperative complications and can lead to worse outcomes after joint replacement surgery. Summary Recent investigations have clearly established a link between these patient-specific factors and poor outcomes after hip and knee arthroplasty, but future research is needed to determine best practices for stratifying and mitigating these risks for patients.

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“…While there are reports that the timing of injection does not correlate with a higher risk of periprosthetic infection, at least a 3-month interval should be considered when possible [1]. This time interval, based upon a reasonable evaluation of the literature, provides a safe time period between intraarticular corticosteroid injections and TKA.…”

Section: How Do We Get There?mentioning

confidence: 99%

“…Many patients, desiring to avoid surgery, choose nonoperative care. It has been reported that up to 30% of patients undergoing a TKA will have an intraarticular corticosteroid injection prior to surgery [1,9]. Despite the frequent use of intraarticular corticosteroid injections, there are no surgeon guidelines regarding the timing and the safety of injections prior to TKA.…”

mentioning

confidence: 99%

“…Despite the frequent use of intraarticular corticosteroid injections, there are no surgeon guidelines regarding the timing and the safety of injections prior to TKA. While many surgeons recommend a delay between intraarticular injection and surgery, there is conflicting information about whether injections before surgery increase the risk of infection afterwards [9,10], and if so, what a safe waiting period might be between an injection and the eventual TKA [1].…”

mentioning

confidence: 99%

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The Risk of a Deep Infection Associated With Intraarticular Injections Before a Total Knee Arthroplasty

Cited by 34 publications

References 15 publications

Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta‐analysis

Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta‐analysis

Factors That Affect Outcome Following Total Joint Arthroplasty: a Review of the Recent Literature

CORR Insights®: The John N. Insall Award: Do Intraarticular Injections Increase the Risk of Infection After TKA?

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