scholarly journals Risk Factor Analysis for Above-knee Amputation in Patients With Periprosthetic Joint Infection of the Knee: a Case-control Study

2021 ◽  
Author(s):  
Franziska Eckers ◽  
Christoph J. Laux ◽  
Sebastian Schaller ◽  
Martin Berli ◽  
Yvonne Achermann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alcohol Abuse ◽  
Periprosthetic Joint Infection ◽  
Case Control Study ◽  
Joint Infection ◽  
Case Control ◽  
Individual Risk ◽  
Preoperative Anemia ◽  
Knee Amputation ◽  
Control Study

Abstract Background: Periprosthetic joint infection (PJI) is a severe complication following knee arthroplasty. Therapeutic strategies comprise a combination of surgical and antibiotic treatment modalities and aim to eradicate the infection. Sometimes control of the disease can only be attained by above-knee amputation (AKA). While a vast amount of literature exists illuminating predisposing factors for PJI, risk factors favoring the endpoint AKA in this context are sparsely known. Methods: The purpose of this investigation was to delineate whether patients with PJI of the knee present specific risk factors for AKA. In a retrospective case-control study 11 cases of PJI treated with AKA were juxtaposed to 57 cases treated with limb salvage (LS). The minimum follow-up was two years. Comorbidities, signs and symptoms of the current infection, factors related to previous surgeries and the implant, microbiology, as well as therapy related factors were recorded. Comparative analysis was performed using student’s t-test, chi-square test or Fisher’s exact test. Binary differences were calculated using odds ratio (OR). Reoperation frequency was compared using Mann-Whitney U test. In-depth descriptive analysis of 11 amputees was carried out. Results: A total of 68 cases aged 71±11.2 years were examined, hereof 11 with AKA and 57 with LS. Severe comorbidities (p=0.009), alcohol abuse (p=0.015), and preoperative anemia (p=0.022) were more frequently associated with AKA. Preoperative anemia was found in all 11 amputees (100%) and in 33 of 57 LS patients (58%) with an average preoperative hemoglobin of 99.9±15.1 g/dl compared to 118.2±19.9 g/dl (p=0.011). No other parameters differed significantly. AKA patients underwent a median of eight (range 2-24) reoperations, LS patients a median of five (range 2-15).Conclusion: Factors potentially influencing the outcome of knee PJI are diverse. The indication of AKA in this context remains a rarity and a case-by-case decision. Patient-intrinsic systemic factors such as alcohol abuse, severe comorbidities and preoperative anemia may elevate the individual risk for AKA in the setting of PJI. We recommend that anemia, being a condition well amenable to therapeutic measures, should be given special consideration in management of PJI patients. Trial registration: This study was registered with Kantonale Ethikkommission Zürich, (BASEC-No. 2016-01048).

scholarly journals Risk Factors for Prosthetic Joint Infection: Case‐Control Study

1998 ◽  
Vol 27 (5) ◽  
pp. 1247-1254 ◽  
Author(s):  
Elie F. Berbari ◽  
Arlen D. Hanssen ◽  
Mary C. Duffy ◽  
James M. Steckelberg ◽  
Duane M. Ilstrup ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prosthetic Joint Infection ◽  
Case Control Study ◽  
Joint Infection ◽  
Case Control ◽  
Prosthetic Joint ◽  
Control Study

scholarly journals Genitourinary Procedures as Risk Factors for Prosthetic Hip or Knee Infection: A Hospital-Based Prospective Case-Control Study

2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Arjun Gupta ◽  
Douglas R. Osmon ◽  
Arlen D. Hanssen ◽  
Deborah J. Lightner ◽  
Walter R. Wilson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Prophylaxis ◽  
Case Control Study ◽  
Joint Infection ◽  
Case Control ◽  
Total Hip ◽  
Control Subjects ◽  
Increased Risk ◽  
The Impact ◽  
Control Study

Abstract Background.  The purpose of this study was to determine the risk of prosthetic joint infection (PJI) as a complication of routine genitourinary (GU) procedures in patients with total hip arthroplasty (THA) or total knee arthroplasty (TKA) and to study the impact of antibiotic prophylaxis administered prior to these procedures. Methods.  We conducted a prospective, single-center, case-control study between December 1, 2001 and May 31, 2006. Case patients were hospitalized with total hip or knee PJI. Control subjects underwent a THA or TKA and were hospitalized during the same period on the same orthopedic floor without a PJI. Data regarding demographic features and potential risk factors were collected. The outcome measure was the odds ratio (OR) of PJI after GU procedures performed within 2 years of admission. Results.  A total of 339 case patients and 339 control subjects were enrolled in the study. Of these, 52 cases (15%) and 55 controls (16%) had undergone a GU procedure in the preceding 2 years. There was no increased risk of PJI for patients undergoing a GU procedure with or without antibiotic prophylaxis (adjusted OR [aOR] = 1.0, 95% confidence interval [CI] = 0.2–4.5, P = .95 and aOR = 1.0, 95% CI = 0.6–1.7, P = .99, respectively). Results were similar in a subset of patients with a joint age less than 6 months, less than 1 year, or greater than 1 year. Conclusions.  Genitourinary procedures were not risk factors for subsequent PJI. The use of antibiotic prophylaxis before GU procedures did not decrease the risk of subsequent PJI in our study.

Risk Factors for Subsequent Diagnosis of Prosthetic Joint Infection

2010 ◽  
Vol 31 (3) ◽  
pp. 298-301 ◽  
Author(s):  
Saima Aslam ◽  
Charles Reitman ◽  
Rabih O. Darouiche
Keyword(s):  
Risk Factors ◽  
Prosthetic Joint Infection ◽  
Odds Ratio ◽  
Case Control Study ◽  
Joint Infection ◽  
Case Control ◽  
Site Infection ◽  
Factors Associated ◽  
Prosthetic Joint ◽  
Control Study

The factors associated with prosthetic joint infection for 126 patients in a case-control study were as follows: bacteremia during the previous year (odds ratio [OR], 4.25 [95% confidence interval {CI}, 1.3–3.8]), nonsurgical trauma to the prosthetic joint (OR, 21.5 [95% CI, 2.6–175.2]), and surgical site infection (OR, 5.25 [95% CI, 1.7–16.7]).

scholarly journals Risk Factors for the Occurrence and Progression of Posttraumatic Elbow Stiffness: A Case-Control Study of 688 Cases

2020 ◽  
Vol 7 ◽  
Author(s):  
Yun Qian ◽  
Shiyang Yu ◽  
Yue Shi ◽  
Hengye Huang ◽  
Cunyi Fan
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Muscle Strength ◽  
Alcohol Abuse ◽  
Case Control Study ◽  
Case Control ◽  
Elbow Stiffness ◽  
Cast Immobilization ◽  
Immobilization Time ◽  
Control Study

Background: Elbow stiffness is a severe complication after trauma. Surgical or conservative treatments may be ineffective for restoring functional elbow motion. We aim to evaluate intrinsic and extrinsic factors for the occurrence and severity of elbow stiffness.Methods: This retrospective case–control study included mild/moderate stiffness, severe stiffness, and non-stiffness groups between January 2011 and December 2017 at a single orthopedic center. Multivariable logistic regression analysis and subgroup analysis were used to evaluate age, gender, body mass index, muscle strength, fracture type and site, injury mechanism, immobilization time, elbow dysfunction time, multiple surgeries, nerve symptoms, physical therapy, smoking and alcohol abuse, and dominant hand of stiff elbow as potential risk factors for the occurrence and severity of elbow stiffness.Results: There were 461 patients in the stiffness group and 227 patients in the non-stiffness group. The odds ratios (ORs) of the age, muscle strength, and injury mechanism were 0.960, 0.333, and 0.216 for the occurrence of elbow stiffness. In subgroup evaluation, increased cast immobilization time might be a risk factor for patients receiving conservative therapies (OR = 2.02; p = 0.014). In the evaluation on factors for progression of elbow stiffness, “multiple surgeries” might be a risk factor in surgical treatment by subgroup analysis (OR = 1.943; p = 0.026). Nevertheless, alcohol abuse might increase severity of elbow stiffness in conservatively treated patients (OR = 3.082; p = 0.025).Conclusion: Increased cast immobilization time in the conservative therapy might be a risk factor for stiffness occurrence. Multiple surgeries might be risk factors for stiffness progression. Alcohol abuse potentially increased stiffness severity after conservative treatment.

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