[Translated article] Risk factors associated with periprosthetic infection in patients with femoral neck fracture: A case-control study

Rev Esp Cir Ortop Traumatol. 2023 Mar-Apr;67(2):T102-T109. doi: 10.1016/j.recot.2022.10.022. Epub 2022 Dec 16.
[Article in English, Spanish]

Abstract

Background: Infection is one of the most important local complications in the patient with femoral neck fracture treated with arthroplasty. The aim of the present study is to describe and analyze possible risk factors that could be involved in periprosthetic infection in the patient with femoral neck fracture.

Methods: A retrospective case-control study was performed including patients with femoral neck fractures treated with arthroplasty in the period between January 2015 and December 2017. Cases were defined as patients with femoral neck fracture who after undergoing arthroplasty (hemiarthroplasty or total hip arthroplasty) had a periprosthetic infection, whose diagnosis was carried out according to the major and minor criteria described in the International Consensus on Musculoskeletal Infections (Philadelphia 2018). In order to mitigate the influence of variables that could be considered confounding variables, a multivariate analysis was carried out.

Outcomes: A statistically significant association was found between periprosthetic infection and certain variables present at the time of admission, including the presence of moderate or severe anaemia (OR: 10.91; 95% CI: 1.07-111.50; P = .007), thrombocytopenia (OR: 27.72;95% CI: 3.48-221.01; P = .002), history of thromboembolism event (OR: 8.80; 95% CI: 1.31-59.38; P = .026), anxious-depressive disorder in treatment with two or three drugs (OR: 21.36; 95% CI: 3.65-125.12; P = .001) and liver disease (OR: 32.04; 95% CI: 2.59-396.29; P = .007).

Conclusions: Periprosthetic infection in the patient with femoral neck fracture treated with arthroplasty could be related to the presence of certain variables at the time of hospital admission, including moderate or severe anaemia, thrombocytopenia, history of thromboembolic event, anxious-depressive disorder in treatment with two or three drugs or liver disease.

Keywords: Artroplastia total de cadera; Femoral neck fractures; Fracturas del cuello femoral; Hemiartroplastia de cadera; Hip hemiarthroplasty; Infección de la artroplastia de cadera; Infección periprotésica de cadera; Infection hip arthroplasty; Infection hip prosthesis; Total hip arthroplasty.

MeSH terms

  • Arthroplasty, Replacement, Hip*
  • Case-Control Studies
  • Femoral Neck Fractures* / complications
  • Femoral Neck Fractures* / surgery
  • Hemiarthroplasty* / adverse effects
  • Humans
  • Periprosthetic Fractures* / etiology
  • Periprosthetic Fractures* / surgery
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome