Risk of deep infection in joint (hip and knee) replacement:evaluation concerning a continuous series of 1 000 cases

摘要

Objective:Few French data concerning prospective surveillance of joint replacement infections are available.This study presents the incidence and characteristics of deep infections in 1 000 consecutive primary hip or knee arthroplasties.Methods:All patients operated between November 1995 and May 1999 were included.Demographic,clinical and therapeutic events were collected.Similarly,data concerning interventions and non-infectious events occurring during hospitalisation were also noted.A deep wound infection was defined mainly with microbiological data obtained from deep per-operative samples performed during a surgical revision of the arthroplasty.Patient follow-up was performed by both telephone call contact and retrospective study of medical and surgical charts.Global and stratified incidences were calculated.Results:The length of patient follow-up after the arthroplasty was at least 12 months for more than 75% of them.The incidence of infections was 1.77% for total hip arthroplasties and 4.29% for total knee arthroplasties.The delay of infection outcome was comprised between 14 days and 32 months.The incidence varied according to the absence (1.7%) or the presence of noninfectious complications (25% for patients with 3 complications).It also varied from 1.1% in patients receiving both systemic and local prophylaxis to 9.7% in the absence of any prophylaxis.Conclusion:The method of patient follow-up used in our study probably allowed us to obtain a reliable information on the incidence of joint arthroplasty infections in our hospital.This relatively high incidence induced us to perform evaluations of practices targeted on antimicrobial prophylaxis and preoperative skin preparation,in order to improve quality in healthcare.