Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Can J Surg. 2008 Apr;51(2):111-7.

Deep infection in total hip arthroplasty.

Author information

  • 1Port Arthur Health Centre, Lakehead University, Thunder Bay, Ontario, Canada. drhenryhamilton@hotmail.com

Abstract

OBJECTIVE:

To report on a 30-year prospective study of deep infection in 1993 consecutive total hip arthroplasties performed by a single surgeon.

METHODS:

The relations of numerous variables to the incidence of deep infection were studied.

RESULTS:

The cumulative infection rate after the index total hip arthroplasties rose from 0.8% at 2 years to 1.4% at 20 years; 9.6% of the index operations required further surgery. When infections attributed to these secondary procedures were included, the infection rate rose from 0.9% at 2 years to 2% at 20 years. Although the usual variables increased the incidence of infection, the significant and most precise predictors of infection were radiologic diagnoses of upper pole grade III and protrusio acetabuli, an elevated erythrocyte sedimentation rate, alcoholism and units of blood transfused.

CONCLUSION:

From 2-20 years, the incidence of deep infection doubled. Preoperative recognition of the first 4 risk factors permits the use of additional prophylactic measures. Spinal or epidural anesthesia reduced the units of blood transfused (the fifth risk factor) and, hence, the risk of infection. Although most deep infections are seeded while the wound is open, there are many possible postoperative causes. In this study, fewer than one-third of the infections that presented after 2 years were related to hematogenous spread. The efficacy of clean air technology was supported, and it is recommended that all measures that may reduce the incidence of deep infection be employed.

PMID:
18377751
[PubMed - indexed for MEDLINE]
PMCID:
PMC2386332
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for The Canadian Medical Association Icon for PubMed Central
    Loading ...
    Write to the Help Desk