- Discussion:
- report by by G. Peersman MD 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.
- diabetes: risk of infection may be well over 3 fold higher;
- references:
- Total knee replacement in patients with diabetes mellitus.
- Total knee arthroplasty in diabetes mellitus.
- rheumatoid arthritis:
- increased infection rate compared with those with osteoarthritis (2-3 fold higher);
- 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;
- references:
- Infection as a complication of total knee replacement arthroplasty. MG Wilson et al. JBJS Vol 72. 1990. p 878-883.
Periprosthetic joint infection: the incidence, timing, and predisposing factors.
