Evaluation of Risk Factors For Acute Periprosthetic Infection Post Total Knee Replacement Iraqi Patients

Shihab, Mahmood; A. Aljumily, Hazim; Salman, Belal; Hamid, Anmar

	Evaluation of Risk Factors For Acute Periprosthetic Infection Post Total Knee Replacement Iraqi Patients
Medical Journal of Babylon
Article 1, Volume 13, Issue 2, 2016, Pages 549-555
Authors
Mahmood Shihab; Hazim A. Aljumily; Belal Salman; Anmar Hamid
Abstract
Periprosthetic joint infection (PJI) is one of the most challenging complications after total joint arthroplasty, with an incidence of 1% to 4% after primary TKA. This complication poses challenges on many aspects, one of which is the difficulty in reaching a diagnosis. Although variation exists, the majority of them rely on the results of joint aspiration or deep tissue culture; serologic tests, namely erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP); and the appearance of the joint during surgery (with regard to presence of purulence); presence or absence of a sinus tract; and the result of histologic analysis of tissue obtained during surgery (frozen section). Taken together, these findings suggest incorporating synovial WBC and PMN% results into a set of diagnostic criteria may improve the strength of those criteria for diagnosing PJI. The Objective is To evaluate the risk factors for peri-prosthetic infection post total knee replacement for Iraqi patients. This prospective study consists of 264 patients (51 males and 213 females) ages ranged from 49-75 years (mean 62 years) had been performed unilateral primary total knee replacement between January 2012 to September 2013 in the Nursing Home Hospital arthroplasty Department, in Baghdad, that are divided into three groups according to the primary pathology, Group I are 207 patients had primary osteoarthritis, Group II are 42 patients had rheumatoid arthritis, and Group III are 15 post-traumatic arthritis. 264 patients with 51 (19.3 %) males and 213 (80.6 %) females’ patients had primary OA 207 case (74.8%), Rheumatoid arthritis 42 case (15.9%) and posttraumatic 15 cases (5.6%). These patients were allocated into 3 groups according to their primary pathology: In Group I, 182 patients (non-diabetic), 4 patients had deep infection, whereas 3 of 25 diabetic patients developed deep infection. In Group II, 34 non diabetic patients, and 8 diabetic patients one and 2 patients had deep infection respectively. Group III, 12 non-diabetic and 3 diabetic patients had one patient each with documented deep wound infection. As a total number of documented acute deep infections during 6 weeks of TKR is 12 cases (4.5%). We conclude that: Diabetic patients are more risk in early postoperative infection than non-diabetic patients. Rheumatoid arthritis adds more incidence of infection to diabetic patients in the TKR. posttraumatic arthritis patients considered as a risk for early postoperative deep infection.
Keywords
TKR; acute deep infection; Diabetic; non

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