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Perioperative and Modifiable Risk Factors for Periprosthetic Joint Infections (PJI) and Recommended Guidelines

Current Reviews in Musculoskeletal Medicine volume 11, pages 325–331 (2018)Cite this article

Abstract

Purpose of Review

Periprosthetic joint infection (PJI) remains a complication that is associated with high morbidity as well as high healthcare expenses. The purpose of this review is to examine patient and perioperative modifiable risk factors that can be altered to help improve rates of PJI.

Recent Findings

Evidence-based review of literature shows that improved control of post-operative glycemia, appropriate management of obesity, malnutrition, metabolic syndrome, preoperative anemia, and smoking cessation can help minimize risk of PJI. Additionally, use of Staphylococcus aureus screening, preoperative evaluation of vitamin D levels, screening for urinary tract infection, and examination of dental hygiene can help with improving rates of PJI; similarly, appropriate management of perioperative variables such as limiting operating room traffic, appropriate timing, and selection of prophylactic antibiotics and surgical site preparation can help to decrease rates of PJI.

Summary

In summary, PJI is a morbid complication of total joint arthroplasty. Surgeons should be vigilant of modifiable risk factors that can be improved upon to help minimize the risk of PJI.

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Affiliations

  1. Department of Orthopaedic Surgery, Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA

    Vignesh K. Alamanda & Bryan D. Springer

  2. OrthoCarolina Hip and Knee Center, Charlotte, NC, USA

    Bryan D. Springer

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  1. Vignesh K. Alamanda
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Correspondence to Bryan D. Springer.

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Conflict of Interest

Bryan D. Springer reports board membership with AJRR and ICJR, consultancy fees from Stryker, Convatec, and Osteoremedies, lecture fees from Ceramtec, and royalties from Stryker, outside of the submitted work.

Vignesh K. Alamanda reports no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Prosthetic Joint Infection

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Alamanda, V.K., Springer, B.D. Perioperative and Modifiable Risk Factors for Periprosthetic Joint Infections (PJI) and Recommended Guidelines. Curr Rev Musculoskelet Med 11, 325–331 (2018). https://doi.org/10.1007/s12178-018-9494-z

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Keywords

  • Periprosthetic joint infection
  • Modifiable risk factors
  • Perioperative risk factors