Perioperative and Modifiable Risk Factors for Periprosthetic Joint Infections (PJI) and Recommended Guidelines

被引:88
作者
Alamanda V.K. [1 ]
Springer B.D. [1 ,2 ]
机构
[1] Department of Orthopaedic Surgery, Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, 28203, NC
[2] OrthoCarolina Hip and Knee Center, Charlotte, NC
关键词
Modifiable risk factors; Perioperative risk factors; Periprosthetic joint infection;
D O I
10.1007/s12178-018-9494-z
中图分类号
学科分类号
摘要
Purpose of Review: Periprosthetic joint infection (PJI) remains a complication that is associated with high morbidity as well as high healthcare expenses. The purpose of this review is to examine patient and perioperative modifiable risk factors that can be altered to help improve rates of PJI. Recent Findings: Evidence-based review of literature shows that improved control of post-operative glycemia, appropriate management of obesity, malnutrition, metabolic syndrome, preoperative anemia, and smoking cessation can help minimize risk of PJI. Additionally, use of Staphylococcus aureus screening, preoperative evaluation of vitamin D levels, screening for urinary tract infection, and examination of dental hygiene can help with improving rates of PJI; similarly, appropriate management of perioperative variables such as limiting operating room traffic, appropriate timing, and selection of prophylactic antibiotics and surgical site preparation can help to decrease rates of PJI. Summary: In summary, PJI is a morbid complication of total joint arthroplasty. Surgeons should be vigilant of modifiable risk factors that can be improved upon to help minimize the risk of PJI. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
引用
收藏
页码:325 / 331
页数:6
相关论文
共 76 条
[1]  
Kurtz S.M., Lau E., Ong K., Zhao K., Kelly M., Bozic K.J., Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030, Clin Orthop Relat Res, 467, 10, pp. 2606-2612, (2009)
[2]  
Bozic K.J., Ries M.D., The impact of infection after total hip arthroplasty on hospital and surgeon resource utilization, J Bone Joint Surg Am, 87, 8, pp. 1746-1751, (2005)
[3]  
Kurtz S.M., Lau E., Watson H., Schmier J.K., Parvizi J., Economic burden of periprosthetic joint infection in the United States, J Arthroplast, 27, pp. 61-5 e1, (2012)
[4]  
Kurtz S., Ong K., Lau E., Mowat F., Halpern M., Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030, J Bone Joint Surg Am, 89, 4, pp. 780-785, (2007)
[5]  
Sculco T.P., The economic impact of infected total joint arthroplasty, Instr Course Lect, 42, pp. 349-351, (1993)
[6]  
Bozic K.J., Kurtz S.M., Lau E., Ong K., Chiu V., Vail T.P., Rubash H.E., Berry D.J., The epidemiology of revision total knee arthroplasty in the United States, Clin Orthop Relat Res, 468, 1, pp. 45-51, (2010)
[7]  
Fehring T.K., Odum S., Griffin W.L., Mason J.B., Nadaud M., Early failures in total knee arthroplasty, Clin Orthop Relat Res, 392, pp. 315-318, (2001)
[8]  
Vessely M.B., Whaley A.L., Harmsen W.S., Schleck C.D., Berry D.J., The Chitranjan Ranawat award: long-term survivorship and failure modes of 1000 cemented condylar total knee arthroplasties, Clin Orthop Relat Res, 452, pp. 28-34, (2006)
[9]  
Kurtz S.M., Lau E., Schmier J., Ong K.L., Zhao K., Parvizi J., Infection burden for hip and knee arthroplasty in the United States, J Arthroplast, 23, 7, pp. 984-991, (2008)
[10]  
Kurtz S.M., Ong K.L., Lau E., Bozic K.J., Berry D., Parvizi J., Prosthetic joint infection risk after TKA in the Medicare population, Clin Orthop Relat Res, 468, 1, pp. 52-56, (2010)