Published online Oct 18, 2022. doi: 10.5312/wjo.v13.i10.903
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
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.
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.
We tried to identify predictive signs of potential infection with the goal of exploring methodological approaches that could better inform daily orthopedic practice.
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.
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.
We did not find any category with a higher risk of PJI in THR, probably due to the lack of few cases of infection.
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.