Risk Factors Of Prosthetic-joint-associated Infections

Hip and knee arthroplasties are accepted by more and more people, because of its wide indications and fairly safety. Although prosthesis infection after joint replacement is not widely seen, it brings patients destructive coup and large psychic pain, of which outcome is two-stage revision. The objective of this article is identifing risk factors of infections after joint replacement, which is analyzed based on the combination of latest internal or foreign literature and our clinical practise.Abese is a independent risk factor associated to infections of prothetic joint, same as diabetes mellitus or cardiacvascular disease. The infection risk of arthroplasty caused by rheumatoid arthritis is much higher than osteoarthritis, due to continued existence of unknown bacteriums rather than patient-sensibility to infection, rheumatoid arthritis patients with the below three factor have more probabilities in infections of prothetic joint, revision arthroplasty, prior infections in surgical joint, long operation persistence. In the same age, sex and operation situation, patients with more than 2 co-morbidities, such as diabete, genitourinary conditions, cardiovascular conditions, hematologic conditions, were more likely to develop infections. Among them, diabete is a independent risk factor for prosthetic infection for its effect to lower white cells' functions. Patients with poor general state of health, or ASA> degree 2, were more likely to develop infections. KSS<45 point for surgical knees, radiologic diagnoses for surgical hips-upper pole grade III(gross loss of head substance, secondary sublu-xation indicated by breaking of Shenton's line), protrusio acetabuli, were associated with a higher incidence of infection. Both partial and complete revision total knee arthroplasty increased the risk of infection as compared with the risk following primary knee replacement. Constrained or hinged prosthetic joints, were more likely to develop infections than cruciate-retaining/posteriorly stabilized prosthetic joints, because its debris inhibit macrophage cells' abilities to swallow bacteriums. Compared to antibioticloaded TKAs, the infection-risk of cemented TKAs was increased significantly both in primary or revision TKA. Allogeneic recipients showed significantly more infections compared to autologous recipients, and the risk increases following the units of blood transfused. Postoperative wound complications including soft tissue defect/dehiscence, hematoma and wound drainage were significant risk factors for periprosthetic infection, which caused by excess anticoagulation. We should pay attentions to these factors in our later practise, to avoid infections after arthroplasty cautiously.