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Risk factors for infection following primary total knee replacement

Linjie Hao, Yumin Zhang, Wei Song, Tao Ma, Jun Wang, Huiguang Cheng, Kun Li, Siqing Qin

Purpose: Information about risk factors can be used to target preventive measure on susceptible patient subgroups. The purpose of study was to determine the risk factors for infection following primary knee replacement.

Methods: Between April 2014 and January 2016, total 1599 primary total knee replacements were carried out in 1374 patients, among them 1161 (933 female and 228 male) cases were available for final study. Patients were divided into without infection and had deep infection. Patients-related risk factors and provider-related risk factors were determined.

Results: Out of 1161 patients, 16 patients had deep infection with infection rate was 1.38 %. There was no significant statistically between age, diagnosis, obesity and malnutrition with infection. Total 16.6 % were smoker, among infected group 37.5% patients were smoker with odds ratio 3.01 and P value 0.013 (<0.05). In study 12.4% patients had diabetics mellitus, in infected group 25% had with odds ratio 2.35 and p value 0.016 (<0.05). Total 2.6% patients had history of steroid use, among infected group 12.5% patients with odds ratio 5.39 and p value less than 0.05. Regarding the provider-related risk factors, mean duration of surgery was 130.9 min and mean duration of hospital stay was 10.95 days with both had no significant statistically. Mean blood loss during surgery was 751.47 ml and mean amount of blood transfusion was 596.08 ml with both had association with infection (p<0.05).

Conclusions: Smoking, diabetes mellitus, steroid use, total blood loss and blood transfusion were significance risk factors for infection after total knee replacement.