The purpose of this study is to evaluate the safety profile and impact on functional results of surgical debridement performed in the early postoperative by comparing them with patients that undergone uncomplicated total joint arthroplasty. This is a retrospective case-control study. Patients that underwent debridement with prosthesis preservation for suspected acute postoperative infection of total hip or knee arthroplasty between 2010–2014 were included. Controls were randomly selected (1:2 ratio) from a list of primary arthroplasty patients in the same time period matching for articulation, age, gender, ASA score, BMI and follow-up time. Infection status, success of treatment and medical-surgical complications were investigated and all patients were assessed using Hip disability and Osteoarthritis Outcome Score(HOOS) or Knee injury and Osteoarthritis Outcome Score(KOOS).Aim
Method
Infection is a complication in hip arthroplasty. It increases mortality and morbidity and is a cause for patient's dissatisfaction. Previous Works report an infection rate between 0,4% e 1,5% in primary hip replacement and between 3,2% in revision hip replacement. The aim of this work was to access the infection rates in one hospital, compare them with the reported rates and investigate possible risk factors for infection. Electronic clinical records were consulted. Patients who underwent total hip arthroplasty (primary or revision) or hemiarthroplasty in one hospital, between the 1st February 2011 and 31st February 2013, were included. Two hundred and sixty one patients (267 surgeries) were included. Demographically, 57,5% were female patients and 42,5% were male patients with an average age of 77,1 years (± 12,3 years). Infection rate for hemiarthroplasty 3,1%, for primary total hip arthroplasty was 1,4% and for revision procedures 4,8%. A statistically significant relation was found between arthroplasty infection and superficial wound infection (p<0,001), wound dehiscence (p<0,001), and surgery performed during summer months (p<0,05) No relation was found with duration of the surgery or the hospital stay or the patient's comorbidities. The infection rate is similar to the rate reported in other clinical centres. Superficial wound complications are a good predictor for arthroplasty infection, so it is important to diagnose and start prompt appropriate management and vigilance. The increase in infection rates in summer months may be related to higher operating room temperature or less routined personal. We concluded, therefore, that infection is a complication in hip arthroplasty being prevention is a key feature when arthroplasty is performed, as well as clinical vigilance for infection signs.
