Prosthetic Joint Infection After Artificial Joint Replacement ——Analysis Of Risk Factors

Background : Prosthetic joint infection（PJI）is one of the most challenging and devastating complications after total hip and knee arthroplasty.Despite the profound and urgent personal and societal impact of PJI,historically,there has been no standardized definition or diagnostic algorithm for infection after total joint replacement.This study provides a clinical reference for the prevention of postoperative infection by retrospectively examining case data of prosthetic infections complicating initial arthroplasty and analyzing the high-risk factors leading to infection.Objective: To investigate the risk factors for prosthetic infection after initial prosthetic joint replacement and to provide a reference for the prevention of prosthetic infection.Methods: The data of patients with prosthetic infection complicated by initial unilateral prosthetic joint replacement from January 2015 to January 2021 at China-Japan union hospital of Jilin University were retrospectively analyzed,and a total of 22 patients were randomly selected as the infection group,and 44 patients without infection who underwent prosthetic joint replacement at the same period at the hospital were selected as the control group.A univariate analysis of personal,surgical,and postoperative factors was performed to compare the differences in risk factors for infection between the two groups of patients.Based on the results of the univariate analysis,a binary logistic regression analysis was performed on the statistically significant risk factors for infection.Results: In this study,the incidence of prosthetic infection after primary hip and knee arthroplasty was 0.73%,1.6% after knee arthroplasty,and0.3% after hip arthroplasty.Binary logistic regression analysis found that operation time,hemoglobin difference,diabetes mellitus,abnormal preoperative CPR,ESR,and positive urinary sediment bacteria were independent risk factors for prosthetic infection after hip and knee arthroplasty.In the bacterial culture of 22 infected patients,14 bacterial strains were isolated,including 7 gram-positive bacteria（50.0%）,6gram-negative bacteria（42.9%）,and 1 fungus（7.1%）.Conclusion: Patients with long operative time,high intraoperative bleeding,diabetes mellitus,abnormal preoperative inflammatory indexes,and positive urinary sediment bacteria are at higher risk of postoperative prosthetic infection,which can provide a reference for clinical infection prevention.