Perioperative Considerations to Reduce Infection Risk in Primary Total Hip and Knee Arthroplasty.

Abstract

* The projected increase in the number of primary total hip and knee arthroplasties is expected to result in a major revision burden over the next decade. A major cause of this revision burden is failed joint arthroplasty secondary to infection.* There are several preoperative, intraoperative, and postoperative factors that can contribute to the development of deep periprosthetic joint infection. Many of the preoperative factors involve appropriate patient selection. Intraoperative factors are directly related to the performance of the operation. Postoperative factors involve management of indwelling catheters, anticoagulation, and prolonged wound drainage.* Identification of these specific risk factors for deep periprosthetic infection and employment of appropriate evidence-based interventions to mitigate these risks can reduce the failure rate of primary hip and knee arthroplasty and can decrease patient morbidity.