Factors influencing postoperative infection in arthroplasties
DOI:
https://doi.org/10.63162/v67n70e26694Keywords:
Infection, Periprosthetic, Total arthroplasty, Risk factors, Surgical site infectionAbstract
Introduction: Periprosthetic infection (PI) is one of the most severe complications of total arthroplasty, with significant impact on morbidity, mortality, and healthcare costs. Objective: To synthesize the available evidence on factors that influence the development of postoperative infections in arthroplasty, providing evidence-based recommendations for clinical practice. Methods: A systematic search was conducted in the PubMed, Web of Science, and Scopus databases for studies published between 2006 and 2023 on periprosthetic infection in total arthroplasty. Observational studies, clinical trials, and meta-analyses evaluating risk factors for periprosthetic infection in total hip arthroplasty (THA) and total knee arthroplasty (TKA) were included. Results: Nine studies were included, totaling approximately 1,200,000 patients. The identified risk factors were classified into: (1) patient-related factors (comorbidities, nutritional status, smoking); (2) surgical factors (surgery duration, procedure type); and (3) hospital and socioeconomic factors. The risk factors most consistently associated with periprosthetic infection were diabetes mellitus (OR = 3.72), obesity (OR = 2.53–4.00), rheumatologic disease (RR = 1.71), smoking (RR = 2.37), prolonged surgical duration, and congestive heart failure. Conclusion: Multiple factors influence the development of postoperative infections in total arthroplasty. Identifying and optimizing these modifiable risk factors is essential to reduce the incidence of periprosthetic infection and improve clinical outcomes.
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