title: Superficial wound infection does not cause inferior clinical outcome after TKA.
abstract: OBJECTIVE
  Superficial wound infections do not lead to chronic prosthetic joint infection. Therefore, it has been hypothesized that a superficial infection of a surgical wound following a successfully treated TKA does not lead to a lower functional outcome at long-term follow-up. This may be due to early diagnosis and proper treatment without interrupting the rehabilitation programme. The purpose of this study was to support the hypothesis by comparing the functional outcome and health-related quality of life (HRQoL) of superficial infections treated successfully after primary total knee arthroplasty (TKA).
  
  
  METHODS
  In a 3000 prospective TKA cohort, 45 superficial infections were compared to a control group of 629 TKA without complications. The functional outcome, health quality, expectations and revision rate were compared between the study and control groups.
  
  
  RESULTS
  The groups were comparable in terms of demographic values and preoperative scores. The mean follow-up was 74.57 months (SD ± 7.1). No statistical differences were observed relative to functional outcomes at the final follow-up as measured with the Knee Society Score (156.9 vs 168.4; n.s) and range of motion (0.2-114.4 vs 0.7-112.3; n.s). For the HRQoL, no differences in the physical (40.0 vs 40.6; n.s) and mental (43.2 vs 45.8; n.s) SF-36 scores were found. Neither were there differences in post-operative expectations and the revision rate.
  
  
  CONCLUSIONS
  In a long-term follow-up, a different clinical outcome and HRQoL were not obtained after a successfully treated superficial infection following a TKA when compared to a TKA without complications. Based on the findings of the study, additional complications are not anticipated after a successfully treated superficial wound infection in TKA. Therefore, a different follow-up to that of a non-complicated TKA is not recommended when the early post-operative superficial wound infection has been appropriately treated. A superficial infection successfully treated in the acute post-operative period should be considered solved at long-term follow-up.
  
  
  METHODS
  Therapeutic study, Level III.
authors: Department of Orthopedic Surgery, Parc de Salut Mar. Hospital de l'Esperança, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain. pguirro@parcdesalutmar.cat.
authors: Pau
authors: http://orcid.org/0000-0001-7432-1139
authors: P
authors: Guirro
authors: Department of Orthopedic Surgery, Parc de Salut Mar. Hospital de l'Esperança, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain.
authors: Pedro
authors: P
authors: Hinarejos
authors: Department of Orthopedic Surgery, Parc de Salut Mar. Hospital de l'Esperança, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain.
authors: Lluís
authors: L
authors: Puig-Verdie
authors: Department of Orthopedic Surgery, Parc de Salut Mar. Hospital de l'Esperança, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain.
authors: Juan
authors: J
authors: Sánchez-Soler
authors: Department of Orthopedic Surgery, Parc de Salut Mar. Hospital de l'Esperança, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain.
authors: Joan
authors: J
authors: Leal-Blanquet
authors: Department of Orthopedic Surgery, Parc de Salut Mar. Hospital de l'Esperança, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain.
authors: Raul
authors: R
authors: Torres-Claramunt
authors: Department of Orthopedic Surgery, Parc de Salut Mar. Hospital de l'Esperança, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain.
authors: Joan-Carles
authors: JC
authors: Monllau
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee; D016022:Case-Control Studies; D003646:Debridement; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D011788:Quality of Life; D016059:Range of Motion, Articular; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Clinical outcome; Functional outcome; Health-related quality of life; Superficial wound infection; Total knee arthroplasty