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Archives of Orthopaedic and Trauma Surgery

Open Access 18-04-2024 | Joint Infection | Knee Arthroplasty

Preventive strategies to reduce the rate of periprosthetic infections in total joint arthroplasty; a comprehensive review

Authors: Omer Faruk Egerci, Aliekber Yapar, Fırat Dogruoz, Huseyin Selcuk, Ozkan Kose

Published in: Archives of Orthopaedic and Trauma Surgery

Abstract

The increasing frequency of total hip (THA) and knee arthroplasties (TKA) is marred by the rise in periprosthetic joint infections (PJIs) and surgical site infections (SSIs), with PJIs incurring costs over $1.62 billion as of 2020 and individual case management averaging $90,000. SSIs additionally burden the U.S. healthcare economy with billions in expenses annually. PJI prevalence in primary THA and TKA ranges from 0.5% to 2.4%, spiking to 20% in revisions and representing 25% of TKA revision causes. Projections estimate up to 270,000 annual PJI cases by 2030. Often caused by gram-positive bacteria, particularly methicillin-resistant staphylococci, these infections demand preventive measures. This review dissects PJI prevention across preoperative, intraoperative, and perioperative phases, aligning with evidence-based CDC and WHO guidelines. Preoperative measures include managing diabetes, obesity, tobacco use, Staphylococcus aureus screening and nasal decolonization, nutritional optimization, and management of inflammatory arthropathies. Intraoperatively, antibiotic prophylaxis, skin preparation, operative room environmental controls, surgical technique precision, and irrigation options are scrutinized. Perioperative concerns focus on anticoagulation, blood management, and infection risk mitigation. Integrating these strategies promotes a patient-centric care model, aiming to reduce PJI incidence, improve patient outcomes, and increase care cost-effectiveness in joint arthroplasty.

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Title: Preventive strategies to reduce the rate of periprosthetic infections in total joint arthroplasty; a comprehensive review
Authors: Omer Faruk Egerci
Aliekber Yapar
Fırat Dogruoz
Huseyin Selcuk
Ozkan Kose
Publication date: 18-04-2024
Publisher: Springer Berlin Heidelberg
Keywords: Joint Infection
Hip-TEP
Hip-TEP
Published in: Archives of Orthopaedic and Trauma Surgery
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-024-05301-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Preventive strategies to reduce the rate of periprosthetic infections in total joint arthroplasty; a comprehensive review

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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