Abstract

There are many studies whose results reveal possible risk factors for developing an infection after a total knee arthroplasty (TKA). The objective of this study is to analyse the risk factors that depend on the hospital and, especially, if the patellar replacement influences the appearance of periprosthetic infection. A retrospective study was performed, where data from the electronic registry of patients of people over 18 and who had undergone TKA, between the years 2015 and 2018, were reviewed. Dependent variables on the patients and the health care system were collected. The possible associations between the factors and the appearance of infection after TKA were studied using univariate and multivariate regression analyses. A total of 907 primary knee arthroplasties were included in the study. Those patients who had their patella replaced had a significantly higher risk of developing an infection (OR 2.07; 95% confidence interval 1.01–6.31). Likewise, patients who underwent surgery by surgeons with more than 10 years of experience were more than twice as likely to become infected than those operated on by younger surgeons (OR 2.64; 95%CI 1.01–6.97). Male patients were also found to be three times more likely to be infected than women (OR 2.99; 95%CI 1.32–5.74). Those interventions that were longer had a higher risk of infection. The same happened with patients who stayed in the hospital for a longer period of time. The rest of the variables did not show statistically significant results. In this study, it was found that the replacement of the patella may be a factor of infection, but it should be corroborated with randomized clinical trials. Furthermore, patients who underwent longer surgeries or those with prolonged hospital stays should be closely monitored to detect infection as soon as possible and establish the most appropriate treatment.

Highlights

  • This study aims to identify risk factors associated with infection after a total knee arthroplasty (TKA)

  • Three out of five and one in five patients had a personal history of high blood pressure and diabetes mellitus (DM), respectively, both pathologies being more prevalent in older patients

  • The anaesthetic risk assessment, performed using the scale proposed by the American Society of Anesthesiologists (ASA), revealed that it was low (I–II) in 80.2% of the patients. 71.44% (n = 648) of the interventions started before 11:00 am, with an average duration of 130.10 minutes (SD ± 23.47)

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Summary

Introduction

Osteoarthritis is one of the most prevalent joint diseases, with great impact on the life quality of the patient. In 2010, it was estimated that about 210 million people were affected by this pathology [1]. Osteoarthritis in the hip and knee joints causes greater social expense and greater associated disability than degenerative changes in other joints [2]. The treatment of this pathology must be meticulous, starting with conservative treatment, such as weight loss, basic analgesia, or low intensity physical exercise, considering that total knee arthroplasty is the last solution to turn to. In cases of very advanced osteoarthritis, TKA can even be considered as the first option [3]

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