Original Article
Presence of Medical Comorbidities in Patients With Infected Primary Hip or Knee Arthroplasties

https://doi.org/10.1016/j.arth.2006.09.002Get rights and content

Abstract

Many older patients undergoing primary hip or knee joint arthroplasty surgery have multiple medical problems. In this retrospective case-control study, the authors examined the individual and cumulative effects of various types of medical comorbidities on the risk of developing prosthetic joint infection after surgery. Case and control patients were matched by age, sex, and procedure. Analysis was undertaken using crude odds ratios (ORs) and multiple logistic regression analysis. Fifty-one patients with 52 joint infections were identified. Both diabetes mellitus (OR, 3.91; P = .04) and total number of medical conditions (OR, 1.35; P = .005) were associated with higher risk of infection. This information allows the orthopedic surgeon to inform patients more fully regarding the risks of surgery, and promotes the reduction and optimization of medical comorbidities before surgery.

Section snippets

Method

Ethical approval was obtained from the author's institutional review board. The case group was identified using the senior authors' ongoing prospective arthroplasty database and consisted of patients referred to our academic arthroplasty unit over a 7-year period for management of a deep infection of a primary hip or knee joint arthroplasty. The diagnosis of infection was confirmed by either positive culture by aspiration preoperatively or by tissue sample at time of surgery, or a clinical

Results

Fifty-one patients with 52 joint infections were identified for the case group; 1 patient had suffered infection of both THA and TKA on separate occasions. The case group was composed of 27 males and 24 females with an average age of 62.5 years, 22 patients had undergone THA, and 30 had undergone TKA. Body mass index information was available for 39 of the patients. The indication for primary arthroplasty was osteoarthritis in 31 cases and rheumatoid arthritis in 4 cases, and could not be

Discussion

In this study, the presence of various medical comorbidities by specific disease and body systems among patients with infected prosthetic joints was compared with those without infection. The presence of diabetes raised the odds of developing a joint infection by almost 4-fold (OR, 3.91). The presence of genitourinary conditions was associated with nearly 3 times increased odds of developing a joint infection (OR, 2.73), although statistical significance was not quite reached in the

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    No benefits or funds were received in support of the study.

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