Prevention of periprosthetic knee joint infections. Experience based on 590 patients treated before and after the introduction of a proprietary protocol

Abstract

Introduction. Total knee arthroplasty is a widely performed procedure in orthopedics. One of its complications is periprosthetic joint infection. Efforts should be made to reduce their frequency by implementing appropriate preventive protocols.Objective. To assess the incidence of infectious complications and their association with comorbidities and to retrospectively evaluate the effectiveness of a polymodal protocol for preventing periprosthetic infections implemented in 2015. Further the paper aims to evaluate the spectrum of pathogens responsible for these complications.Materials and methods. A total of 590 cases were analyzed, 277 of which were operated on before the preventive protocol was introduced and 313 after its implementation.Results. Eleven cases of periprosthetic joint infections were diagnosed. Prolonged wound healing was observed in older individuals and diabetic patients. Increased risk of periprosthetic infections was found in obese individuals and those with inflammatory arthropathies. The implemented protocol did not impact the overall incidence of infectious complications in the studied population but a reduction in complications was observed in diabetic patients. The most commonly isolated pathogens were coagulase-negative Staphylococcus, followed by Staphylococcus aureus.Conclusions. The implemented protocol was effective in diabetic patients. The identified pathogens corresponded to those typically observed in periprosthetic infections in Europe.

Keywords

• periprosthetic infection
• periprosthetic infection prevention
• surgical site infection
• total knee arthroplasty