Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta-analysis

Abstract

To identify risk factors for periprosthetic joint infection following primary total joint arthroplasty, a systematic search was performed in Pubmed, Embase and Cochrane library databases. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Patient characteristics, surgical-related factors and comorbidities, as potential risk factors, were investigated. The main factors associated with infection after total joint arthroplasty (TJA) were male gender (OR, 1·48; 95% CI, 1.19–1.85), age (SMD, −0·10; 95% CI, −0.17–−0.03), obesity (OR, 1·54; 95% CI, 1·25–1·90), alcohol abuse (OR, 1·88; 95% CI, 1·32–2·68), American Society of Anesthesiologists (ASA) scale > 2 (OR, 2·06; 95% CI, 1·77–2·39), operative time (SMD, 0·49; 95% CI, 0·19–0·78), drain usage (OR, 0·36; 95% CI, 0·18–0·74), diabetes mellitus (OR, 1·58; 95% CI, 1·37–1·81), urinary tract infection (OR, 1·53; 95% CI, 1.09–2.16) and rheumatoid arthritis (OR, 1·57; 95% CI, 1·30–1·88). Among these risk factors, ASA score > 2 was a high risk factor, and drain usage was a protective factor. There was positive evidence for some factors that could be used to prevent the onset of infection after TJA.

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