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New variables leading to periprosthetic infections found for TKA, THA patients

Study on joint infections looks at over 9,000 cases and finds race, ASA scores and other predisposing factors previously unidentified.

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SAN DIEGO — A study of 9,245 primary total knee and hip arthroplasty patients has identified some new significant variables that lead to the development of periprosthetic infection. Investigators also confirmed the existence of some factors already tied to these infections.

Luis Pulido, MD, and his colleagues at the Rothman Institute in Philadelphia found new independent primary predisposing factors for periprosthetic infection (PPI) following joint replacement in this large cohort as follows: race (Hispanics), higher American Society of Anesthesiologists (ASA) scores, simultaneous bilateral surgery, postoperative atrial fibrillation, myocardial infarction and urinary tract infection. The investigators identified those predisposing factors after performing multiple logistic regression analyses.

Most PPIs turn up within the first year following index arthroplasty, he said.

"Before we can prevent, we must know how to prevent, in this case periprosthetic infection, and we must know what the predictors of infection look like," Pulido said in a podium presentation at the Musculoskeletal Infection Society's 17th Annual Open Scientific Meeting, held here.

The researchers collected data for this prospective study from the database at the Rothman Institute between January 2001 and December 2006. Sixty-three patients (0.7% of the total) developed PPI, Pulido noted in the abstract.

The group looked at many variables in reaching their conclusions, including operative time, pre- and postoperative lab reports (hemoglobin, creatine, white blood count and glucose levels), comorbidities and perioperative complications.

For more information:

• Pulido L, Parvizi J, Ghanem E, et al. Predictors of periprosthetic joint infection. Presented at the Musculoskeletal Infection Society 17th Annual Open Scientific Meeting. Aug. 10-11, 2007. San Diego.