Wound infection in hip and knee arthroplasty.
We have studied prospectively the outcome of wound discharge in patients after arthroplasty of the hip and knee. Over a period of 3.5 years 530 primary arthroplasties were carried out in one hospital. Postoperative wound infections developed in 82. At a mean follow-up of two years a comparison was made between these patients and 82 with healthy wounds, in terms of symptoms and signs of deep infection. There was an incidence of 1.1% of early deep infection, within six weeks in all cases. The rate of 'superficial' infection was 17.3% in the hips, 10.5% in the knees and 14.3% in total. At a mean follow-up of 26 months, there were no significant differences between the patients with infected wounds and a matched group of patients with healthy wounds in terms of the ESR, level of C-reactive protein, white cell count and radiological scores, but clinical scores were significantly worse in the patients with infected knees (p < 0.05). The length of stay was also significantly longer in this group (mean 14.6 days in the healthy wound group, 19 days in the problem group; p < 0.005). There was, however, no convincing evidence that these wound infections led to deep infection and early revision in the early to medium follow-up period. A larger and longer prospective trial would be necessary to shed more light on this potential problem.
Gaine
W J
WJ
Department of Orthopaedics, Southern General Hospital, Glasgow, Scotland, UK.
Ramamohan
N A
NA
Hussein
N A
NA
Hullin
M G
MG
McCreath
S W
SW
D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data; D006622:Hip Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data; D011184:Postoperative Period; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000145:classification / Q000175:diagnosis; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000145:classification / Q000175:diagnosis*; D013997:Time Factors