Tella GF, Donadono C, Castagnini F, Bordini B, Cosentino M, Di Liddo M, Traina F. Preoperative and postoperative risk factors for periprosthetic joint infection in primary total hip arthroplasty: A 1-year experience . World J Orthop 2022; 13(10): 903-910 [PMID: 36312522 DOI: 10.5312/wjo.v13.i10.903]
Corresponding Author of This Article
Cesare Donadono, MD, Doctor, Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Cesare Pupilli 1, Bologna 40125, Italy. c.donadono@gmail.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Oct 18, 2022; 13(10): 903-910 Published online Oct 18, 2022. doi: 10.5312/wjo.v13.i10.903
Preoperative and postoperative risk factors for periprosthetic joint infection in primary total hip arthroplasty: A 1-year experience
Giuseppe Ferdinando Tella, Cesare Donadono, Francesco Castagnini, Barbara Bordini, Monica Cosentino, Michele Di Liddo, Francesco Traina
Giuseppe Ferdinando Tella, Cesare Donadono, Francesco Castagnini, Michele Di Liddo, Francesco Traina, Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Bologna 40125, Italy
Barbara Bordini, Monica Cosentino, Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna 40125, Italy
Author contributions: Tella GF, Donadono C, Castagnini F, Bordini B, Cosentino M, Di Liddo M, and Traina F contributed equally to all aspects of this work.
Institutional review board statement: The study was reviewed and approved by the Comitato Etico di Area Vasta Emilia Centro della Regione Emilia-Romagna (CE-AVEC), Approval No. 0005172.
Informed consent statement: Informed written consent was obtained from the patient.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at c.donadono@gmail.com. Consent was not supposed to be obtained because of the characteristics of the study and the impossibility to contact the patient but by the way the presented data are anonymized and risk of identification is low.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cesare Donadono, MD, Doctor, Ortopedia-Traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Cesare Pupilli 1, Bologna 40125, Italy. c.donadono@gmail.com
Received: December 24, 2021 Peer-review started: December 24, 2021 First decision: February 15, 2022 Revised: February 27, 2022 Accepted: September 9, 2022 Article in press: September 9, 2022 Published online: October 18, 2022 Processing time: 296 Days and 18.3 Hours
ARTICLE HIGHLIGHTS
Research background
Periprosthetic joint infection (PJI) in primary total hip replacement (THR) is one of the most important challenges in orthopedic surgery, so one important surgeon’s goal is to avoid or diagnose a PJI early.
Research motivation
The incidence of PJI is very low (0.69%) in our department, with an average follow-up of 595 d. This infection poses a serious threat due to the difficulties of treatment and the lower functional outcomes after healing.
Research objectives
We tried to identify predictive signs of potential infection with the goal of exploring methodological approaches that could better inform daily orthopedic practice.
Research methods
We counted 583 THR for 578 patients and observed only 4 cases of infection (0.69%) with a mean follow-up of 596 d (min 30 max 1451). We reviewed duration and time of the surgery, presence, type and duration of the antibiotic therapy, preoperative diagnosis, blood values before and after surgery, transfusions, presence of preoperative drugs, and presence of some comorbidities to look for statistically significant differences between the patients that did and did not develop a PJI.
Research results
No preoperative, intraoperative, or postoperative analysis showed a higher incidence of PJI. We did not find any class with evident major risk of PJI. Some categories, such as female patients, showed a higher frequency of PJI, but this difference related to sex was not statistically significant.
Research conclusions
We did not find any category with a higher risk of PJI in THR, probably due to the lack of few cases of infection.
Research perspectives
PJI is an important topic and more research about the subject is needed. Probably due to the low number of cases, especially in the PJI group (4 cases), we did not attain the results we were expecting. Future studies are needed to add new information to the scientific literature, for example, data spanning 5 years or combined from multiple centers.
