Periprosthetic infection after total hip replacement : Risk factors for an early infection after primary implantation

Abstract

Periprosthetic infection is one of the most serious complications in primary arthroplasty. The infection rates reported in the current literature range from 0.36 to 2.23%. The aim of this retrospective case-control study was to determine preoperative risk factors for the occurrence of early periprosthetic infection after primary hip arthroplasty. The influence of patient age, gender, body mass index (BMI), C‑reactive protein, preoperative leukocyte count and morbidity level (American Society of Anaesthesiologists score) on the occurrence of periprosthetic early infection of the hip joint was examined, and their correlation was investigated. Of the 1383patients followed up, 25were diagnosed with early infection. With an increase in BMI of 1 kg/m2, the risk of periprosthetic early infection increased by 12.1% (p < 0.001). In addition, using the receiver operating characteristic (ROC) curve, aBMI ≥ 29 kg/m2 is identified as asignificant cut-off for the increased likelihood of periprosthetic hip infection. Using the ROC curve, apreoperative CrP value > 5 mg/l can be validated as acut-off value for an increased risk of early infection. Using binary logistic regression, no influence of CrP > 5 mg/l on the development of early infection was statistically proven (p = 0.065). Patients with aBMI ≥ 29 kg/m2 should be informed about the increased risk of periprosthetic early infection after hip prosthesis implantation and arisk assessment should be performed. Furthermore, the determination of the preoperative CrP value should be considered standard.