What factors impact surgical site infection risk following joint arthroplasty? 15 examples

Orthopedic

A study in the Journal of Bone & Joint Surgery developed a scoring system to assess surgical site infection risk prior to joint arthroplasty.

The researchers identified 6,789 patients who underwent knee and hip arthroplasty. They defined surgical site infection as a superficial infection that occurred within 30 days or a deep infection that occurred within one year. The researchers used their findings to create a scoring system for surgical site infection risk, which ranged from zero points to 35 points.

 

Here are their scores for risk of infection based on procedure:

 

1. Primary hip arthroplasty: 0 points

2. Primary knee arthroplasty: 1 point

3. Revision hip arthroplasty; revision knee arthroplasty: 3 points

 

Here are their scores for risk of infection based on comorbidities:

 

1. Non-insulin dependent diabetes: 1 point

2. Chronic obstructive pulmonary disease: 1 point

3. Insulin-dependent diabetes: 1.5 points

4. Inflammatory arthropathy: 1.5 points

5. Tobacco use: 1.5 points

6. Lower-extremity osteomyelitis or pyogenic arthritis: 2 points

7. Pelvis, thigh or leg traumatic fracture: 2 points

8. Lower-extremity pathologic fracture: 2.5 points 

9. Morbid obesity: 2.5 points

10. Primary bone cancer: 4 points

11. Reaction to prosthesis in the last 3 years: 4 points

12. History of staphylococcal septicemia: 4.5 points

 

The researchers concluded that "we believe that infection risk can be objectively determined in a preoperative setting with the proposed SSI risk score."

 

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