Rodríguez BM, Albornoz SH, Costa AC, Saona OG, Rey NR

Language: Spanish
References: 20
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ABSTRACT

Introduction: Total hip arthroplasty infections have a low incidence, but when they occur they generate health problems for the patient, and for the health system. They can cause pain, decreased functional capacity, poor quality of life, multiple surgeries, and sometimes death.
Objectives: To evaluate the national incidence of infections in primary hip arthroplasties operated for osteoarthritis in 2014, and the risk factors related to the patient, the environment and the surgical act, including the surgical approach.
Methods: Analytical observational study of all patients operated on for osteoarthritis. A random sample of 633 patients was selected, representative of 1738 arthroplasties performed in Uruguay in 2014. Through a telephone interview and review of medical records, patients with deep infection of the surgical site were identified. The incidence of infection was estimated and univariate and multivariate analysis was performed using logistic regression to identify factors associated with deep periprosthetic infection.
Results: There were 8 infections, with an incidence of 1.21% (95% CI 0.59 - 2.20) in the general population. The statistically significant factors associated with prosthetic infection were: a) BMI ≥ 35, p = 0.006; b) origin of Montevideo 2.07% (1.03 - 4.11) p = 0.031; c) origin of the private subsector 1.47% (0.77 - 2.78) p = 0.009; d) surgical center where the surgery was performed 4.3% (1.6 - 10.9) p = 0.03, e) use of cement with antibiotic 1.59% (0.65 - 3.25) p = 0.034. Suspicion of infection was presented in 6 of 8 patients, in the first 30 postoperative days; 7 of 8 patients underwent surgical cleaning and only 1 of 8 patients underwent final prosthetic revision.
Conclusions: The incidence of infection in elective prosthetic hip surgery for osteoarthritis in the Uruguayan National Registry was similar to that published in the literature. Body mass index was the only variable associated as incidental to this complication in this series, out of those frequently cited. The associations depending on the origin, socioeconomic level and surgical center are striking. The results regarding the use of cement with antibiotics should be evaluated in future studies.

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