Infections in Total Hip and Total Knee Arthroplasty: Development of a Score To Assess Endogenous Risk of Surgical Site Infections

Abstract Background: Surgical site infections (SSI) are a dreaded complication of total hip (THA) and knee arthroplasties (TKA), and are a major public health concern. Risk factors are well known, but no endogenous risk assessment score exists. The objective of this study to develop a score to assess endogenous risk of infection after THA or TKA. Methods: All infections after TKA and THA implanted in the department of orthopedic surgery of a teaching hospital between January 2007 and December 2012 were included. Two control groups were matched to cases on the type of prosthesis (hip or knee; first-line or revision). Results: Twenty-four SSIs after THA and 21 after TKA were registered (respective incidence during the study period: 1.56 and 1.91%). Relevant endogenous risk factors found were: Smoking (adjusted odds ratio=3.9), a BMI greater than 35 kg/mC (1.8), inflammatory rheumatism (7.3), and the number of operations (prosthetic or not) on the involved joint (2.9 per additional surgery). The average scor...