Wound infection in hip and knee arthroplasty

J Bone Joint Surg Br. 2000 May;82(4):561-5. doi: 10.1302/0301-620x.82b4.10305.

Abstract

We have studied prospectively the outcome of wound discharge in patients after arthroplasty of the hip and knee. Over a period of 3.5 years 530 primary arthroplasties were carried out in one hospital. Postoperative wound infections developed in 82. At a mean follow-up of two years a comparison was made between these patients and 82 with healthy wounds, in terms of symptoms and signs of deep infection. There was an incidence of 1.1% of early deep infection, within six weeks in all cases. The rate of 'superficial' infection was 17.3% in the hips, 10.5% in the knees and 14.3% in total. At a mean follow-up of 26 months, there were no significant differences between the patients with infected wounds and a matched group of patients with healthy wounds in terms of the ESR, level of C-reactive protein, white cell count and radiological scores, but clinical scores were significantly worse in the patients with infected knees (p < 0.05). The length of stay was also significantly longer in this group (mean 14.6 days in the healthy wound group, 19 days in the problem group; p < 0.005). There was, however, no convincing evidence that these wound infections led to deep infection and early revision in the early to medium follow-up period. A larger and longer prospective trial would be necessary to shed more light on this potential problem.

MeSH terms

  • Arthroplasty, Replacement, Hip* / statistics & numerical data
  • Arthroplasty, Replacement, Knee* / statistics & numerical data
  • Hip Prosthesis / adverse effects
  • Hip Prosthesis / statistics & numerical data
  • Humans
  • Knee Prosthesis / adverse effects
  • Knee Prosthesis / statistics & numerical data
  • Postoperative Period
  • Prospective Studies
  • Prosthesis-Related Infections / classification
  • Prosthesis-Related Infections / diagnosis
  • Statistics, Nonparametric
  • Surgical Wound Infection / classification
  • Surgical Wound Infection / diagnosis*
  • Time Factors