Arthroplasty-center related retrospective analysis of risk factors for Periprosthetic Joint Infection after primary and after revision Total Hip Arthroplasty

Article type: Research Article

Authors: Radtke, Kerstin^{a; *} | Tetzlaff, T.^a | Vaske, B.^b | Ettinger, M.^a | Claaßen, L.^a | Flörkemeier, T.^a | Windhagen, H.^a | Lewinski, G. von^a

Affiliations: [a] Department of Orthopaedic Surgery, Hannover Medical School, Hanover, Germany | [b] Institute of Medical Biometry and Informatics, Hannover Medical School, Hanover, Germany

Correspondence: [*] Corresponding author: Kerstin Radtke, Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany. Tel.: +49 511 5354 847; Fax: +49 511 5354 682; E-mail:[email protected]

Abstract: BACKGROUND: Periprosthetic Joint Infection (PJI) poses a great challenge to patients, surgeons and health care systems. Comorbid diseases and patient-related risk factors are poorly understood. OBJECTIVE: The purpose of this study was to evaluate patient-related risk factors for PJI after primary and after revision Total Hip Arthroplasty (THA). METHODS: In the present study, data was collected from 566 patients who underwent primary or revision THA between July 2011 and June 2012 in an established arthroplasty center (Endocert certified endoprosthesis center, EPZmax). The effects of demographic data and comorbid diseases on revision operations within 18 months following THA were analyzed using descriptive and explorative statistics. RESULTS: It was shown, that alcohol abuse, depression, preoperative ESBL (Extended Spectrum ß-Lactamase bacteria) infection, elevated preoperative serum-CRP (C-reactive protein), extended operation-time, extended length of hospital-stay, intraoperative complications, perioperative urinary tract infections and postoperative antibiotic therapy are significantly related to PJI in primary THA. CONCLUSIONS: Comorbid diseases seem to influence outcome after THA. They are important for predicting revision operations and implant survival. In severe high-risk cases, they can lead to perform the operation under precaution or to avoid performing the operation entirely. This should reduce PJI occurrences in future.

Keywords: Risk factors, periprosthetic joint infection, PJI, Total Hip Arthroplasty

DOI: 10.3233/THC-161158

Journal: Technology and Health Care, vol. 24, no. 5, pp. 721-728, 2016