Abstract
Abstract. Introduction The number of total joint arthroplasties performed globally has increased over time, and the projected growth for total knee arthroplasty (TKA) and total hip arthroplasty (THA) in 2030-2050 is associated with an increase in the number of surgical complications, such as periprosthetic joint infection (PJI). Perioperative modifiable risk factors can be altered to help improve rates of the devastating scenario. The purpose of the review was to systematize information on modifiable risk factors for PJI after THA and TKA and the ways to improve them. Material and methods Scientific literature search was performed via web-based services of PubMed, eLibrary, Scopus, Dimensions. The search depth was 30 years. Results Modifiable risk factors were shown to be associated with the patient's condition, medical history, current status, intraoperative and postoperative surgical options. Well-established modifiable risk factors include tobacco use, alcohol consumption, excess body weight, obesity, malnutrition, duration of surgery, postoperative wound hematoma. Discussion Timely diagnosed modifiable risk factors for PJI can be improved at the preparation stage, perioperatively and postoperatively. The interaction of inpatient and outpatient hospital services in the perioperative period is essential for reducing the risk of PJI after THA and TKA.
Highlights
The number of total joint arthroplasties performed globally has increased over time, and the projected growth for total knee arthroplasty (TKA) and total hip arthroplasty (THA) in 2030-2050 is associated with an increase in the number of surgical complications, such as periprosthetic joint infection (PJI)
The search was carried out using keywords in Russian and English: hip arthroplasty, knee arthroplasty, PJI (‘periprosthetic joint infection’), surgical site infections (SSIs) (‘surgical site infection’), ‘predict’, ‘risk factor’
Consensus Meeting on Musculoskeletal Infection, identified (98 % votes in the affirmative, with a strong level of evidence) modifiable factors related to the patient and nonmodifiable factors (older age, male sex, black ethnicity) with an increased risk of developing SSI/PJI) [21]
Summary
The number of total joint arthroplasties performed globally has increased over time, and the projected growth for total knee arthroplasty (TKA) and total hip arthroplasty (THA) in 2030-2050 is associated with an increase in the number of surgical complications, such as periprosthetic joint infection (PJI). Perioperative modifiable risk factors can be altered to help improve rates of the devastating scenario. A very high implant survival rate of 95 % is reported at ten years, 3 % of patients may have early complications during the first 30 days after surgery that would require a revision intervention [9]. Surgical site infection is one of the most common and devastating complications of TJR that can develop in the first days after surgery [10–16]. Accurate identification of individuals at high risk of surgical site infections (SSIs) or periprosthetic joint infections (PJIs) influences clinical decisions and development of preventive strategies. Risk stratification can help identify those patients at risk of adverse outcomes that can be prevented preoperatively, intraoperatively and postoperatively
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