Risk Factors for Prosthetic Joint Infection after Primary Hip Arthroplasty

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Abstract

Prosthetic joint infection (PJI) after primary hip arthroplasty (PHA) in most cases results in severe surgical and socio-economic problems. Along with improving the technical support of arthroplasty and antibiotic prevention schemes, a key point in reducing the rate of infectious complications is predicting of PJI in each individual patient. The purpose of the study was to reveal the key features of our patients with infectious complications after PHA in comparison with the patients with a successful outcome of arthroplasty. Materials and Methods. The outcomes of 249 cases of PHA were evaluated retrospectively. 115 of them subsequently developed PJI (main group) and 134 were without infectious complications (control group). The comparative analysis of the groups was aimed at identifying the key preoperative, intraoperative and postoperative factors for PJI, as well as combinations of the factors characteristic for our patients. Results. The risk group for the development of infectious complications included patients undergone hip surgery (p<0.001), body mass index >40 kg/m2 (p = 0.170), preoperative hemoglobin <115 g/L (p = 0.063), duration of the operation >90 min (p<0.001), intraoperative blood loss >410 ml (p<0.001), CRP >69 mg/L on day 4 th to 5 th after PHA (p<0.001), as well as a combination of 4 or more of the above factors (p<0.001). Conclusion. We believe that the correction of the management tactics of such patients taking into account the identified risk factors will reduce the incidence of PJI after PHA.

About the authors

A. A. Myasoedov

Vreden National Medical Research Center of Traumatology and Orthopedics

Author for correspondence.
Email: aamyasoedov@rniito.ru

Alexey A. Myasoedov — Cand. Sci. (Med.), Researcher

St. Petersburg

Россия

S. S. Toropov

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru

Sergey S. Toropov — Orthopaediс Surgeon

St. Petersburg

Россия

G. V. Berezin

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru

Georgiy V. Berezin — Assistant Researcher

St. Petersburg

Россия

V. V. Karelkin

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru

Vitaliy V. Karelkin — Cand. Sci. (Med.), Head of Department

St. Petersburg

Россия

Z. A. Totoev

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru

Zaurbek A. Totoev — Assistant Researcher

St. Petersburg

Россия

I. I. Shubnyakov

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: fake@neicon.ru

Igor I. Shubnyakov — Dr. Sci. (Med.), Chief Researcher

St. Petersburg

Россия

R. M. Tikhilov

Vreden National Medical Research Center of Traumatology and Orthopedics; Mechnikov North-Western State Medical University

Email: fake@neicon.ru

Rashid M. Tikhilov — Dr. Sci. (Med.), Professor, Director, Vreden National Medical Research Center of Traumatology and Orthopedics; Professor, Traumatology and Orthopedics Department, Mechnikov North-Western State Medical University

St. Petersburg

Россия

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