Infection After Primary Total Hip Arthroplasty

Abstract

The number of primary total hip arthroplasties (THAs) performed in the United States each year continues to climb, as does the incidence of infectious complications. The changing profile of antibiotic-resistant bacteria has made preventing and treating primary THA infections increasingly complex. The goal of this review was to summarize (1) the published data concerning the risk of surgical site infection (SSI) after primary THA by type of bacteria and (2) the effect of potentially modifying factors. The Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, EMBASE, Web of Science, and PubMed were searched. Studies dated between 2001 and 2011 examining primary THA in adults were included. Meta-analysis of the collected data was performed. The pooled SSI rate was 2.5% (95% confidence interval [Cl], 1.4%-4.4%; P<.001; n=28,883). The pooled deep prosthetic joint infection (PJI) rate was 0.9% (95% Cl, 0.4%-2.2%; P<.001; n=28,883). The pooled rate of methicillin-resistant Staphylococcus aureus SSI was 0.5% (95% Cl, 0.2%-1.5%; P<.001; n=26,703). This is approximately 20% of all SSI cases. The pooled rate of intraoperative bacterial wound contamination was 16.9% (95% Cl, 6.6%-36.8%; P=.003; n=2180). All these results had significant heterogeneity. The postoperative risk of SSI was significantly associated with intraoperative bacterial surgical wound contamination (pooled rate ratio, 2.5; 95% Cl, 1.4%-4.6%; P=.001; n=19,049).

The Effect of Implementing a Multimodal Approach on the Rates of Periprosthetic Joint Infection After Total Joint Arthroplasty

“…Infection rates after TJA are dependent on many factors including patient comorbidities, operative time, operating room environment, and perioperative risk reduction interventions [3,8,[27][28][29][30][31][32][33][34][35][36]. Reported rates of PJI after TJA are highly variable and range from 0.5% to 3.3% in the early postoperative period [1,[3][4][5]28,37].…”

“…In 2013, PJI occurred in only 4 of 1,053 TJA patients. Conclusion: We found that formation of an IRC focused on evaluating and implementing strategies to reduce PJI following TJA can be effective.Periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) is a significant complication associated with substantial morbidity and cost [1][2][3][4][5]. There are multiple risk factors that increase a patient's likelihood for developing a PJI: comorbidities, preoperative care, surgical factors, and postoperative factors.…”

Antibacterial and Biocompatible Titanium-Copper Oxide Coating May Be a Potential Strategy to Reduce Periprosthetic Infection: An In Vitro Study

“…These infections occur after 0.4% to 2.2% primary THAs and TKAs [24,25,46]. For patients undergoing tumor megaprosthetic implantation, the risk is greater, estimated at 4% to 45% [28].…”

Topical Negative Pressure Therapy and Interactive Dressings in Prevention of Wound Infections in High-Risk Orthopaedic Patients

“…The incidence of infectious complications occurring after surgical implant placement reaches 3 to 12 per cent [6], while surgical site infections (SSI) following the replacement of big joints is observed in 2.5 per cent of cases [7], in addition, the risk of periprosthetic infection increases 3.3 times in case of revisional prosthetic repair [8]. The number of joint replacement surgeries is on the rise across the world, however the incidence of infectious complications associated with this kind of intervention gains even more momentum [9].…”