The Hip: Preservation, Replacement and Revision

Risk Factors for Infection in TKR:

- Discussion:
          - 
methods to prevent infection
          - report by by Peersman G, et al .
                  - comorbidities that were statistically significant in increasing the risk of infection were prior open surgical
                              procedures, immunosuppressive therapy, poor nutrition, hypokalemia, diabetes mellitus, obesity, and
                              a history of smoking.
          - prevalence of infection after TKA may be higher than after total hip arthroplasty;
          - obesity:
                  - references:
                          - Obesity and perioperative morbidity in total hip and total knee arthroplasty patients. 
                          - Obese Diabetic Patients are at Substantial Risk for Deep Infection after Primary TKA
                          - Infection in total knee replacement: a retrospective review of 6489 total knee replacements.
          - diabetes: risk of infection may be well over 3- 7 fold higher; 
          - rheumatoid arthritis:
                  - increased infection rate compared with those with osteoarthritis (2-3 fold higher); 
                  - ref: Patient-related risk factors for periprosthetic joint infection and postoperative mortality following total hip arthroplasty in Medicare patients.

         - anemia:
                   - references:
                         - Patient-related risk factors for periprosthetic joint infection and postoperative mortality following total hip arthroplasty in Medicare patients.
                         - Risk Factors for Surgical Site Infection Following Total Joint Arthroplasty
                         - The pre-operative levels of haemoglobin in the blood can be used to predict the risk of allogenic blood transfusion after total knee arthroplasty.

         - atrial fibrillation
                   - ref: Patients with Atrial Fibrillation Undergoing Total Joint Arthroplasty Increase Hospital Burden
         - avoidance of injections within 3 month of surgery:
                   - ref: The Timing of Total Hip Arthroplasty after Intra-Articular Hip Injection Affects Postoperative Infection Risk

          - previous surgical procedures:
                  - have been shown to increase the risk of infection, but previous arthroscopic procedures have not;
          - psoriasis: rate of infection may be as high as 17%;
          - hinged prostheses: particularly metal on metal type, but not w/ the use of unicondylar prostheses;
          - pre-operative skin ulcerations: strongly associated w/ postoperative infection;
          - vitamin D deficiency:
                  - Vitamin D deficiency in patients with osteoarthritis undergoing total hip replacement: a cause for concern?
                  - Is there an association between periprosthetic joint infection and low vitamin D levels?

            - hepatitis C:
                  - The Impact of Hepatitis C on Short-Term Outcomes of Total Joint Arthroplasty

          - rivaroxaban:
                  -  Rivaroxaban use for Thrombosis Prophylaxis is Associated with Early Periprosthetic Joint Infection

          - ? laminar flow:
                  - The impact of patient and surgical factors on the rate of infection after primary total knee arthroplasty. An analysis of 64 566 joints from the New Zealand Joint Registry
                           of 64 566 joints from the New Zealand Joint Registry



          - references:
                  - Infection as a complication of total knee replacement arthroplasty. Risk factors and treatment in sixty-seven cases.












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Periprosthetic joint infection: the incidence, timing, and predisposing factors.

Polymicrobial prosthetic joint infections: risk factors and outcome.

Prosthetic Joint Infection Risk after TKA in the Medicare Population

Postoperative Infection Rates in Foot and Ankle Surgery: A Comparison of Patients with and without Diabetes Mellitus

Complications for Racial and Ethnic Minority Groups After Total Hip and Knee Replacement: a review of the literature

Alternatives to Total Knee Replacement:  Autologous Hamstring Resurfacing Arthroplasty



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, June 9, 2016 8:51 am