Portal de Periódicos da CAPES

Infection After Primary Total Hip Arthroplasty

2014; Slack Incorporated (United States); Volume: 37; Issue: 4 Linguagem: Inglês

10.3928/01477447-20140401-08

1938-2367

Bennie Lindeque, Zach Hartman, Andriy Noshchenko, Peggy Cruse,

Surgical site infection prevention

Educational Objectives As a result of reading this article, physicians should be able to: 1. Understand contemporary postoperative infection rates for primary total hip arthroplasty (THA). 2. Understand the epidemiology of bacterial species responsible for postoperative primary THA infections. 3. Review current interventions to decrease the primary THA infection rate. 4. Assess the volume and quality of data in the current orthopedics literature regarding primary THA infections. The number of primary total hip arthroplasties (THAs) performed in the United States each year continues to climb, as does the incidence of infectious complications. The changing profile of antibiotic-resistant bacteria has made preventing and treating primary THA infections increasingly complex. The goal of this review was to summarize (1) the published data concerning the risk of surgical site infection (SSI) after primary THA by type of bacteria and (2) the effect of potentially modifying factors. The Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, EMBASE, Web of Science, and PubMed were searched. Studies dated between 2001 and 2011 examining primary THA in adults were included. Meta-analysis of the collected data was performed. The pooled SSI rate was 2.5% (95% confidence interval [Cl], 1.4%–4.4%; P <.001; n=28,883). The pooled deep prosthetic joint infection (PJI) rate was 0.9% (95% Cl, 0.4%–2.2%; P <.001; n=28,883). The pooled rate of methicillin-resistant Staphylococcus aureus SSI was 0.5% (95% Cl, 0.2%–1.5%; P <.001; n=26,703). This is approximately 20% of all SSI cases. The pooled rate of intraoperative bacterial wound contamination was 16.9% (95% Cl, 6.6%–36.8%; P =.003; n=2180). All these results had significant heterogeneity. The postoperative risk of SSI was significantly associated with intraoperative bacterial surgical wound contamination (pooled rate ratio, 2.5; 95% Cl, 1.4%–4.6%; P =.001; n=19,049). [ Orthopedics. 2013; 37(4):257–265.]