Control of Cement Penetration in Total Knee Arthroplasty

Walker, PS; SOUDRY, M.; Ewald, Frederick C.; MCVICKAR, H.

doi:10.1097/00003086-198405000-00026

Cited by 137 publications

(98 citation statements)

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“…There are no clear guidelines to support either delaying or postponing joint arthroplasty because of the presence of bacteriuria with no systemic symptoms [2,9,13,15]. There also are no prospective studies documenting any correlation between the preoperative bacteriuria and deep joint infection [1,15,36,43] (Table 4).…”

Section: Discussionmentioning

confidence: 99%

“…There also are no prospective studies documenting any correlation between the preoperative bacteriuria and deep joint infection [1,15,36,43] (Table 4). However, several case reports and small case series suggest an association between postoperative UTI and joint infection [7,8,17,21,28].…”

Section: Discussionmentioning

confidence: 99%

“…In orthopaedic surgery, UTI as a source for joint infection is the subject of controversy [9,36,41]. Some authors suggest UTI should be treated before the joint arthroplasty [9] whereas others have stated there are no well-documented data to support the association between UTI and joint infection [15,36,41]. Some authors report an association between postoperative bladder catheterization and subsequent joint infection [7,28,30].…”

Section: Introductionmentioning

confidence: 99%

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Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

Koulouvaris¹,

Sculco²,

Finerty³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Surgical wound infection is a serious and potentially catastrophic complication after joint arthroplasty. Urinary tract infection is a common infection that creates a potential reservoir of resistant pathogens and increases patient morbidity. We asked whether treated preoperative and postoperative urinary tract infections are risk factors for deep joint infection. We examined the medical records of 19,735 patients. The minimum had joint infections develop. Of these, three had preoperative and four had postoperative urinary tract infections. The majority of bacteria were not enteric. The bacteria in the two types of infections were not identical. Control subjects were randomly selected from a list of patients matched with patients having infections. Of these, eight had preoperative and one had postoperative urinary tract infections. We found no association between the preoperative urinary tract infection (odds ratio, 0.341; 95% confidence interval, 0.086-1.357) or postoperative urinary tract infection (odds ratio, 4.222; 95% confidence interval, 0.457-38.9) and wound infection. Only one of the 58 patients with wound infections had a urinary tract infection with the same bacteria in both infections. Given the infection rate was very low (0.29%), the power of the study was only 25%. Although limited, the data suggest patients with urinary tract infections had no more likelihood of postoperative infection. We believe treated urinary tract infection should not be a reason to delay or postpone surgery. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship Between Perioperative Urinary Tract Infection and Deep Infection After Joint Arthroplasty

Koulouvaris¹,

Sculco²,

Finerty³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…Urinary tract infection (UTI) is the second most common hospital-based infection, accounting for more than one-third of infections acquired whilst in hospital with an incidence of 25-28% [19]. The risk of mortality is increased by a factor of 3 in patients with a UTI, and there is an increased risk of metastatic infection around joint replacements, although the statistical significance of this incidence remains controversial [1,6,21].…”

Section: Introductionmentioning

confidence: 99%

Urinary infection after orthopedic procedures

Herruzo-Cabrera

López-Giménez

Cordero

et al. 2001

International Orthopaedics (SICOT)

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We have investigated prospectively the incidence of urinary tract infection (UTI) in 5320 orthopaedic patients. There were 74 UTIs (1.39%). Enterobacteriaceae was the most frequent etiological agent. Each infection increased the length of stay in hospital by more than 8 days. Statistically independent risk factors for the development of urinary infection were a preoperative stay of more than 4 days, inadequate preoperative preventive measures, central venous catheterization and urinary catheterization. Sex, age, or type of surgery had no statistical influence on the development of infection.

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“…On the other hand, asymptomatic patients with bacteriuria may safely undergo TJA provided routine prophylactic antibiotics are administered. Patients with obstructive symptoms should undergo urologic evaluation before arthroplasty, as postoperative urinary retention has been shown to be a risk factor for PJI (40)(41)(42).…”

Section: Resultsmentioning

confidence: 99%