Respiratory Infections, Repeat Surgeries Up SSI Risk in Total Joint Arthroplasty

hip and knee arthoplasties
hip and knee arthoplasties
Total knee arthroplasty is more commonly linked to surgical site infection compared to total hip arthroplasty.

This article is part of Infectious Disease Advisor’s in-depth coverage of IDWeek 2017™, which took place in San Diego, CA. Our staff will be reporting on the latest treatment advancements and research initiatives for skin infections. Check back regularly for highlights from IDWeek 2017.

Up to 2.5% of people undergoing total joint arthroplasties experience surgical site infections, according to research presented at IDWeek 2017 in San Diego, California. Among these patients, recent respiratory infections and additional surgeries within 90 days of arthroplasty increase patients’ infection risk.

Researchers conducted a retrospective cohort study of patients treated at the Detroit Medical Center between 2011 and 2015 (n=2255; mean age: 58.8±11; 64% female) who underwent either primary or revision total knee or hip joint arthroplasty (knee arthroplasty: 53%; hip arthroplasty: 47%). Patients were grouped by the presence of a prosthetic joint infection.

Surgical site infection was more likely to develop in patients who had respiratory tract infection within 30 days prior to surgery (20% vs 6.6%; odds ratio: 3.42; 95% CI, 1.62-7.22; P =.0034). Conversely, diabetes, administration of general anesthesia, American Society of Anesthesiologists score ≥2, hypothermia, or hypoglycemia did not increase surgical site infection risk. Additional surgeries — within 90 days of arthroplasty — increased patients’ risk for infection (22% vs 11%; P =.03), with knee surgeries more commonly linked to infection vs hip surgeries (67% vs 33%; P =.07).

“Careful preoperative assessment and sufficient time to postoperative recovery is essential to reduce [surgical site infections],” the researchers concluded, noting that future multicenter studies would validate current findings.

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Navalkele B, Krishna A, McKelvey G, et al. Recent respiratory tract infection and additional surgeries increase risk for surgical site infection in total joint arthroplasty: a retrospective analysis of 2255 patients. Presented at: IDWeek 2017; October 4-8, 2017; San Diego, CA. Abstract 229.