Rates of infection and revision in patients with renal disease undergoing total knee replacement in Scotland

J Bone Joint Surg Br. 2010 Nov;92(11):1535-9. doi: 10.1302/0301-620X.92B11.23870.


We undertook a study to determine the rates of infection and revision of total knee replacement (TKR) in patients with renal failure, renal transplantation and those undergoing renal dialysis in Scotland. The overall early and late infection rates were 1.10% and 2.19% compared with 1.06% and 2.01%, respectively, for non-renal patients. Patients with renal failure had a significantly increased risk of early infection (1.6%, relative risk 1.52, p = 0.002) and late infection (4.47%, relative risk 2.22, p < 0.001). Those on renal dialysis had significantly increased risks of late infection (8.03%, relative risk 3.99, p < 0.001) and early revision (3.70%, relative risk 4.40, p < 0.001). Renal transplant patients had a significantly increased risk of late infection, regardless of whether renal transplantation occurred before TKR (9.09%, relative risk 4.517, p = 0.027) or at any time (8.0%, relative risk 3.975, p = 0.047). There were significantly increased rates of comorbidities associated with infection for all the renal patient groups. Logistic regression analysis showed that renal failure and renal dialysis were independent risk factors for early infection and revision, respectively.

MeSH terms

  • Arthroplasty, Replacement, Knee / adverse effects*
  • Female
  • Humans
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / therapy
  • Kidney Transplantation
  • Male
  • Postoperative Period
  • Prospective Studies
  • Prosthesis-Related Infections / complications*
  • Renal Dialysis
  • Reoperation / statistics & numerical data
  • Risk Factors