The Journal of Arthroplasty
Volume 25, Issue 8 , Pages 1216-1222.e3, December 2010

Incidence and Risk Factors for Deep Surgical Site Infection After Primary Total Hip Arthroplasty: A Systematic Review

  • Donna M. Urquhart, PhD

      Affiliations

    • Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia
    • Corresponding Author InformationReprint requests: Donna Urquhart, PhD, Department of Epidemiology and Preventive Medicine, Monash University–Central and Eastern Clinical School, Alfred Hospital, Commercial Rd, Melbourne 3004, Victoria, Australia.
    • ,
  • Fahad S. Hanna, PhD

      Affiliations

    • Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia
    • Baker IDI Heart and Diabetes Institute, PO Box 6492, Victoria 8008, Australia
    • Joint first author.
    • ,
  • Sharon L. Brennan, BA(Hons)

      Affiliations

    • Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia
    • ,
  • Anita E. Wluka, PhD

      Affiliations

    • Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia
    • Baker IDI Heart and Diabetes Institute, PO Box 6492, Victoria 8008, Australia
    • ,
  • Karin Leder, PhD

      Affiliations

    • Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia
    • ,
  • Peter A. Cameron, MD

      Affiliations

    • Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia
    • ,
  • Stephen E. Graves, DPhil

      Affiliations

    • Department of Medicine, Melbourne University, Royal Melbourne, Hospital, Royal Parade, Parkville, Victoria, Australia
    • ,
  • Flavia M. Cicuttini, PhD

      Affiliations

    • Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia

Received 22 April 2009; accepted 19 August 2009. published online 02 November 2009.

Abstract 

Although deep surgical site infection (SSI) is a major complication of primary total hip arthroplasty (THA), there are conflicting data regarding the incidence of deep SSI, and no comprehensive evaluation of the associated risk factors has been undertaken. We performed a systematic review of the literature; undertaking computer-aided searches of electronic databases, assessment of methodological quality, and a best-evidence synthesis. The incidence of SSI ranged from 0.2% before discharge to 1.1% for the period up to and including 5 years post surgery. Greater severity of a pre-existing illness and a longer duration of surgery were found to be independent risk factors for deep SSI. There is a need for high-quality, prospective studies to further identify modifiable risk factors for deep SSI after THA.

Keywords: hip arthroplasty/replacement, infection, incidence, risk factor, systematic review

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 Supplementary material available at www.arthroplastyjournal.org.

 Benefits or support were received from the HCF Health and Medical Research Foundation. National Health and Medical Research Council Fellowship and PhD Schemes.

PII: S0883-5403(09)00411-2

doi:10.1016/j.arth.2009.08.011

The Journal of Arthroplasty
Volume 25, Issue 8 , Pages 1216-1222.e3, December 2010

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