Risk factors for periprosthetic joint infection after total hip arthroplasty and total knee arthroplasty in Chinese patients

PLoS One. 2014 Apr 18;9(4):e95300. doi: 10.1371/journal.pone.0095300. eCollection 2014.

Abstract

Purpose: The purpose of this hospital-based case-control study was to evaluate the risk factors for periprosthetic joint infection (PJI) of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in Chinese patients.

Method: From January 2000 to December 2012, 45 patients undergoing THA and TKA who developed PJI were recruited for case subjects; controls were 252 without PJI, matched by year of index for surgery and type of surgery. Conditional logistic regressions were run to compute odds ratios (ORs) and 95% confidence intervals (CIs).

Results: Demographic factors and comorbid conditions associated with an increased adjusted risk of PJI (in decreasing order of significance) were diabetes (OR = 5.47, 95% CI: 1.77-16.97; p = 0.003), age (65-75 vs. 45-65 years) (OR = 3.36, 95% CI: 1.30-8.69; p = 0.013), BMI (≥28 vs. 18.5-28 kg/m2) (OR = 2.77, 95% CI: 1.20-6.40; p = 0.017), place of residence (rural) (OR = 2.63, 95% CI: 1.13-6.10; p = 0.025) and alcohol abuse (OR = 2.95, 95% CI: 1.06-8.23; p = 0.039).

Conclusion: Patients with diabetes, older age, BMI of ≥28 kg/m2 and alcohol abuse or living in rural areas, had increased PJI risk. Additional systematic large-scale studies are needed to verify these results.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Case-Control Studies
  • China
  • Female
  • Humans
  • Infections / etiology*
  • Joint Prosthesis*
  • Male
  • Middle Aged
  • Risk Factors
  • Surgical Wound Infection / etiology*

Grants and funding

This work was supported by grants from the National Natural Science Foundation of China (No. 81171729 and No. 81301590), Major Basic Research of Science and Technology Commission of Shanghai Municipality (Grant No. 11DJ1400303), and Fund for Key Disciplines of Shanghai Municipal Education Commission (J50206). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.