Periprosthetic fractures associated with high rate of postoperative wound complications
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Surgical management of hip and knee periprosthetic fractures was associated with high rates of wound complications after total hip and knee arthroplasties, according to published results.
In their retrospective study, researchers analyzed 67 patients who underwent consecutive periprosthetic hip and knee fracture surgeries at a single institution from January 2010 to January 2016, Outcomes included nonoperative complications, such as superficial surgical site infection (SSI), prolonged drainage and would dehiscence, as well as operatively treated complications, such as aggressive superficial SSI and deep infection, according to the study.
“The majority of fractures treated were in the femur (90%), and the main procedures were revision of a femoral component of a THA (33%), revision of both components of a THA (15%) and open reduction internal fixation of a femoral shaft fracture (15%),” the researchers wrote in the study.
The overall wound complication rate was 22% (15 patients), with 16% (11 patients) of complications treated operatively and 6% (four patients) treated nonoperatively.
“Patients with a history of vascular disease, pulmonary disease and prior bariatric surgery were significantly more likely to have one of these wound complications, whereas the use of closed-incision negative-pressure therapy (NPT) was associated with a decreased risk for developing a wound complication,” the researchers concluded.
“Future payment models should reflect this elevated level of complications and risk,” the researchers added. “Future studies should be directed at investigating the potential protective effects of NPT in this high-risk population,” they wrote.
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