BACKGROUND: Periprosthetic joint infection (PJI) is a devastating complication after total hip arthroplasty (THA). The potential to define and modify risk factors for infection represents an important opportunity to reduce the incidence of PJI. This study uses New Zealand Joint Registry data to identify independent risk factors associated with PJI after primary THA. METHODS: Data on 91,585 THAs performed between 2000 and 2014 were analyzed. Factors associated with revision for PJI within 12 months were identified using univariate and multivariate analyses. RESULTS: Revision rates for PJI were 0.15% and 0.21% at 6 and 12 months, respectively. Multivariate analysis showed significant associations with the American Society of Anesthesiologists grade (odds ratio [OR] 6.13, 95% confidence interval [CI] 1.28-29.39), severe or morbid obesity (OR 2.15, CI 1.01-4.60 and OR 3.73, CI 1.49-9.39), laminar flow ventilation (OR 1.98, CI 1.38-2.85), consultant-supervised trainee operations (OR 1.94, CI 1.22-3.08), male gender (OR 1.68, CI 1.23-2.30) and anterolateral approach (OR 1.62, CI 1.11-2.37). Procedures performed in the private sector were protective for revision for infection (OR 0.68, CI 0.48-0.96). CONCLUSIONS: The PJI risk profile for patients undergoing THA is constituted of a complex of patient and surgical factors. Several patient factors had strong independent associations with revision rates for PJI. Although surgical factors were less important, these may be more readily modifiable in practice.
BACKGROUND: Periprosthetic joint infection (PJI) is a devastating complication after total hip arthroplasty (THA). The potential to define and modify risk factors for infection represents an important opportunity to reduce the incidence of PJI. This study uses New Zealand Joint Registry data to identify independent risk factors associated with PJI after primary THA. METHODS: Data on 91,585 THAs performed between 2000 and 2014 were analyzed. Factors associated with revision for PJI within 12 months were identified using univariate and multivariate analyses. RESULTS: Revision rates for PJI were 0.15% and 0.21% at 6 and 12 months, respectively. Multivariate analysis showed significant associations with the American Society of Anesthesiologists grade (odds ratio [OR] 6.13, 95% confidence interval [CI] 1.28-29.39), severe or morbid obesity (OR 2.15, CI 1.01-4.60 and OR 3.73, CI 1.49-9.39), laminar flow ventilation (OR 1.98, CI 1.38-2.85), consultant-supervised trainee operations (OR 1.94, CI 1.22-3.08), male gender (OR 1.68, CI 1.23-2.30) and anterolateral approach (OR 1.62, CI 1.11-2.37). Procedures performed in the private sector were protective for revision for infection (OR 0.68, CI 0.48-0.96). CONCLUSIONS: The PJI risk profile for patients undergoing THA is constituted of a complex of patient and surgical factors. Several patient factors had strong independent associations with revision rates for PJI. Although surgical factors were less important, these may be more readily modifiable in practice.
Authors: Alexander J Acuña; Michael T Do; Linsen T Samuel; Daniel Grits; Jesse E Otero; Atul F Kamath Journal: Arch Orthop Trauma Surg Date: 2021-09-30 Impact factor: 2.928
Authors: Claudia A M Löwik; Wierd P Zijlstra; Bas A S Knobben; Joris J W Ploegmakers; Baukje Dijkstra; Astrid J de Vries; Greetje A Kampinga; Glen Mithoe; Aziz Al Moujahid; Paul C Jutte; Marjan Wouthuyzen-Bakker Journal: PLoS One Date: 2019-04-08 Impact factor: 3.240
Authors: Mikko S Venäläinen; Valtteri J Panula; Riku Klén; Jaason J Haapakoski; Antti P Eskelinen; Mikko J Manninen; Jukka S Kettunen; Ari-Pekka Puhto; Anna I Vasara; Keijo T Mäkelä; Laura L Elo Journal: JB JS Open Access Date: 2021-01-25
Authors: Valtteri J Panula; Kasperi J Alakylä; Mikko S Venäläinen; Jaason J Haapakoski; Antti P Eskelinen; Mikko J Manninen; Jukka S Kettunen; Ari-Pekka Puhto; Anna I Vasara; Laura L Elo; Keijo T Mäkelä Journal: Acta Orthop Date: 2021-07-01 Impact factor: 3.717