Arthroplasty-center related retrospective analysis of risk factors for Periprosthetic Joint Infection after primary and after revision Total Hip Arthroplasty.
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.
Department of Orthopaedic Surgery, Hannover Medical School, Hanover, Germany.
Kerstin
K
Radtke
Department of Orthopaedic Surgery, Hannover Medical School, Hanover, Germany.
T
T
Tetzlaff
Institute of Medical Biometry and Informatics, Hannover Medical School, Hanover, Germany.
B
B
Vaske
Department of Orthopaedic Surgery, Hannover Medical School, Hanover, Germany.
M
M
Ettinger
Department of Orthopaedic Surgery, Hannover Medical School, Hanover, Germany.
L
L
Claaßen
Department of Orthopaedic Surgery, Hannover Medical School, Hanover, Germany.
T
T
Flörkemeier
Department of Orthopaedic Surgery, Hannover Medical School, Hanover, Germany.
H
H
Windhagen
Department of Orthopaedic Surgery, Hannover Medical School, Hanover, Germany.
G von
Gv
Lewinski
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000453:epidemiology; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002097:C-Reactive Protein / Q000032:analysis; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016459:Prosthesis-Related Infections / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult; D001618:beta-Lactamases / Q000302:isolation & purification
D002097:C-Reactive Protein; D001618:beta-Lactamases
PJI; Risk factors; Total Hip Arthroplasty; periprosthetic joint infection