scholarly journals Assessment of risk factors for early-onset deep surgical site infection following primary total hip arthroplasty for osteoarthritis

2021 ◽  
Vol 6 (9) ◽  
pp. 443-450
Author(s):  
Jonathan Bourget-Murray ◽  
Rohit Bansal ◽  
Alexandra Soroceanu ◽  
Sophie Piroozfar ◽  
Pam Railton ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Hip Arthroplasty ◽  
Early Onset ◽  
Site Infection ◽  
Total Hip ◽  
Deep Surgical Site Infection ◽  
Primary Total Hip Arthroplasty

Abstract. The aim of this study was to determine the incidence, annual trend, and perioperative outcomes and identify risk factors of early-onset (≤90 d) deep surgical site infection (SSI) following primary total hip arthroplasty (THA) for osteoarthritis. We performed a retrospective study using prospectively collected patient-level data from January 2013 to March 2020. The diagnosis of deep SSI was based on the published Centre for Disease Control/National Healthcare Safety Network (CDC/NHSN) definition. The Mann–Kendall trend test was used to detect monotonic trends. Secondary outcomes were 90 d mortality and 90 d readmission. A total of 22 685 patients underwent primary THA for osteoarthritis. A total of 46 patients had a confirmed deep SSI within 90 d of surgery representing a cumulative incidence of 0.2 %. The annual infection rate decreased over the 7-year study period (p=0.026). Risk analysis was performed on 15 466 patients. Risk factors associated with early-onset deep SSI included a BMI > 30 kg m−2 (odds ratio (OR) 3.42 [95 % CI 1.75–7.20]; p<0.001), chronic renal disease (OR, 3.52 [95 % CI 1.17–8.59]; p=0.011), and cardiac illness (OR, 2.47 [1.30–4.69]; p=0.005), as classified by the Canadian Institute for Health Information. Early-onset deep SSI was not associated with 90 d mortality (p=0.167) but was associated with an increased chance of 90 d readmission (p<0.001). This study establishes a reliable baseline infection rate for early-onset deep SSI after THA for osteoarthritis through the use of a robust methodological process. Several risk factors for early-onset deep SSI are potentially modifiable, and therefore targeted preoperative interventions of patients with these risk factors is encouraged.

scholarly journals Methicillin-resistant Staphylococcus aureus colonization in patients undergoing primary total hip arthroplasty

2020 ◽  
Vol 69 (4) ◽  
pp. 600-604
Author(s):  
Daniel Schweitzer ◽  
Ianiv Klaber ◽  
Patricia García ◽  
Felipe López ◽  
María Jesús Lira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Risk Factor ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Antibiotic Use ◽  
Rt Pcr ◽  
Total Hip ◽  
Mrsa Colonization ◽  
Primary Total Hip Arthroplasty

Introduction. Nasal and skin colonization by methicillin-resistant Staphylococcus aureus (MRSA) are linked to a higher incidence of infection after total joint replacement. The prevalence of colonization is poorly defined in Latin American countries. Aim. The aim of the present study was to determine the prevalence of MRSA colonization in the nostrils and groin using real-time polymerase chain reaction (RT-PCR) in patients undergoing total hip arthroplasty (THA). Methodology. In this cross-sectional study, 146 patients undergoing THA between December 2015 and March 2017 in a tertiary-care university-affiliated hospital in Chile were screened for MRSA colonization before the procedure using RT-PCR independently in the nostrils and groin. Risk factors for colonization were documented. Results. Seven of the 146 (5 %) patients undergoing THA were carriers of MRSA in the nostrils and/or the groin. Recent antibiotic use was identified as a risk factor for colonization, OR=4.86 [95 % confidence interval (CI): 1.56–13.96]. Patients reporting at least one of the seven surveyed risk factors had an OR of 2.39 (95 % CI: 0.37–25.77) for colonization. MRSA colonization frequency was twofold higher in the groin as opposed to the nostrils (P=0.014). Conclusion. Five percent of the patients undergoing THA were identified as carriers of MRSA. Recent antibiotic use is a relevant risk factor for MRSA colonization in patients undergoing primary total hip arthroplasty.

scholarly journals Conversion of Failed Hip Resurfacings to Total Hip Arthroplasty- A Favorable Solution with Satisfactory Outcomes

2021 ◽  
Author(s):  
Abdel-hamid A Atalla ◽  
Abdel-hamid ◽  
Bahaa A Kornah ◽  
Mohamed Abdel-AAl ◽  
Abdel-Aleem Soltan
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Surgical Site Infection ◽  
Heterotopic Ossification ◽  
Hip Arthroplasty ◽  
Groin Pain ◽  
Hip Resurfacing ◽  
Site Infection ◽  
Total Hip

Abstract Background: Hip resurfacing had been utilized since the 1950s. The concept favored for young active patients owing to its proposed advantages. Revision rate of hip resurfacing in most national registries nearly 3.5%. Conversion to total hip replacement may be the correct option for old patients and those whose activity levels changed and the need for hip resurfacing no longer required.Purpose: The aim of this study is to assess the mid-term outcomes of converting failed hip resurfacing arthroplsty to total hip arthroplasty. Primary outcomes included improvement of Oxford, WOMAC, Harris and UCLA hip scores. Also; radiological follow-up has been evaluated for component stability or signs of loosening. Secondary outcomes included surgical site infection, residual groin pain, and heterotopic ossification. Most of patients (22 patients (88%) reported relief of pain and good to excellent patient satisfaction. Study design: Prospective case series study.Level of evidence: Therapeutic IV.Patients and Methods:Twenty–five patients (fifteen males) with failed hip resurfacing arthroplasty converted to total hip arthroplasty enrolled in this study. Mean age 56.8 years. Mean time to revision 36.8 months. Indications for revision included: femoral neck fractures (10 cases), femoral neck thinning (3 cases), component loosening (4 cases) component dislocation (2 cases) persistent groin pain and clicking (3 cases) and wear of components (3 cases). Nineteen patients revised both components while remaining six underwent revision of femoral component only. Results:The average duration of follow up was 26.8 months (28-48 months). The study was an intermediate term follow-up. Clinical outcome evaluated through Oxford, WOMAC, Harris and UCLA hip scores. Preoperative scores 21.3, 78.3, 35,7 and 2 respectively improved to 39.8, 11.1, 92.3 and 7 respectively at last follow-up representing statistically significant improvements over pre-operative scores (p < 0.0001 for each score) Radiological follow-up evaluated for component stability or signs of loosening. No cases of neurological, vascular, deep infection or implant failure. There were 3 cases (3%) with complications. one case complicated by surgical site infection with serous drainage for more than seven days and treated with oral antibiotics and daily dressings. One case had residual groin pain, and third case had mild heterotopic ossification. All patients were satisfied particularly by their pain relief. Average post operative Oxford, Harris and WOMAC hip scores were 17.4, 89.8 and 6.1 respec-tively. representing statistically significant improvements over pre operative scores (p < 0.0001 for each score)Conclusions: study shows conversion of hip resurfacing to THA has high satisfaction rates. These results compare favorably with those for revision total hip arthroplasty

Incidence and risk factors for neuropathy following primary total hip arthroplasty

2017 ◽  
Vol 27 ◽  
pp. S27
Author(s):  
J. Nguyen ◽  
E. Su ◽  
S. Lyman ◽  
E. Manning ◽  
K. Cummings ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty
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