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Risk factors for deep infection after total knee arthroplasty: a meta-analysis

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Objective

Estimated the risk factors for postoperative infection after total knee arthroplasty (TKA) to prevent its occurrence.

Design

The meta-analysis collected twelve cohorts or case–control studies which included 548 infected persons in 57,223 general cases. Review Manager 5.0 was operated to assess the heterogeneity and to give an overall estimate of the association of factors with postoperative infection after TKA.

Results

The main factors distinctly associated with infection after TKA were BMI (BMI >30: OR = 2.53, 95 % CI 1.25, 5.13; BMI >40: OR = 4.00, 95 % CI 1.23, 12.98), diabetes mellitus (OR = 3.72, 95 % CI 2.30, 6.01), hypertension (OR = 2.53, 95 % CI 1.07, 5.99), steroid therapy (OR = 2.04, 95 % CI 1.11, 3.74), and rheumatoid arthritis (OR = 1.83; 95 % CI 1.42, 2.36). It had no sufficient evidences to reveal that gender could lead to infection after TKA. Osteoarthritis appeared to have a moderately protective effect. Statistical analysis revealed no correlation between urinary tract infection, fixation method, ASA, bilateral operation, age, transfusion, antibiotics, bone graft, and infection.

Conclusion

There were positive evidences for some certain factors which could be targeted for prevention of the onset of infection, but more studies are needed to define the association of some other controversial factors in infection, like osteoarthritis, gender and so on. The quality of studies also needs to be improved.

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Acknowledgments

It is a pleasure to acknowledge the support from Professor Tian Jing. Thanks to his enlightenment in the process of selection of the topic and publication title of study. What is more, he took time from his busy schedule to revise our paper and gave us valuable comments on the draft version of the paper. His instruction gave us great help in the completion of our study.

Conflict of interest

There is no conflict of interest and the paper has not been submitted elsewhere.

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Authors and Affiliations

  1. The Second Clinical Medical College of Southern Medical University, No.253, Gongye Avenue, Haizhu, Guangzhou, 510282, Guangdong, China

    Jie Chen, Yunying Cui, Xin Li, Xiangwan Miao, Zhanpeng Wen & Yan Xue

  2. Zhujiang Hospital, Southern Medical University, No.253, Gongye Avenue, Haizhu, Guangzhou, 510282, Guangdong, China

    Jing Tian

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  1. Jie Chen
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  2. Yunying Cui
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  3. Xin Li
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Corresponding author

Correspondence to Jing Tian.

Additional information

J. Chen, Y. Cui, X. Li, X. Miao, Z. Wen, Y. Xue and J. Tian contributed equally to this paper.

Appendix

Appendix

Figure 9; Tables 4, 5

Fig. 9
figure 9

Flow chart for study selection References

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Table 4 Characteristics of the studies on deep infection after total knee arthroplasty
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Table 5 Distribution of factors among selected articles
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Chen, J., Cui, Y., Li, X. et al. Risk factors for deep infection after total knee arthroplasty: a meta-analysis. Arch Orthop Trauma Surg 133, 675–687 (2013). https://doi.org/10.1007/s00402-013-1723-8

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  • DOI: https://doi.org/10.1007/s00402-013-1723-8

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