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Reducing surgical site infections following total hip and knee arthroplasty: an Israeli experience

MUSCULOSKELETAL SURGERY volume 101, pages 219–225 (2017)Cite this article

A Correction to this article was published on 12 October 2017

This article has been updated

Abstract

Purpose

To assess the changes observed in surgical site infection (SSI) rates following total joint arthroplasty (TJA) after the introduction of an infection control programme and evaluate the risk factors for the development of these infections.

Design

Prospective cohort study.

Setting

Large tertiary medical centre in Israel.

Methods

Data about SSIs and potential prophylaxis-, patient-, and procedure-related risk factors were collected for all patients who underwent elective total hip and total knee arthroplasty during the study period. Multivariant analyses were conducted to determine which significant covariates affected the outcome.

Results

During the 76-month study period, SSIs (superficial and deep) occurred in 64 (4.4%) of 1554 patients. As compared with the 34 (7.7%) SSIs that occurred in the first 25 months, there were 23 (4.7%) SSIs in the following 25 months, and only 7 (1.3%) SSIs in the last third of the study (p = 0.058 and <0.001, respectively). A multiple logistic regression model indicated that risk factors for prosthetic joint infection were a National Nosocomial Infections Surveillance (NNIS) System surgical patient risk index score of 1 (OR 1.8; 95% CI 1.1–3.1) or 2 (OR 2.8; 95% CI 1.2–11.8). The incidence of SSI was not correlated with the timing, nor the duration of antibiotic prophylaxis.

Conclusions

The introduction of preventive measures and surveillance coincided with a significant reduction in SSIs following TJA in our institution. The risk of infection correlated with higher scores in the NNIS System surgical patient risk.

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Fig. 1

Change history

  • 12 October 2017

    In the original article, one of the co-author’s family name has been published incorrectly.

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Author information

Affiliations

  1. Infectious Diseases Unit, Rambam Medical Center, Rechov Alia Shnia, 31096, Haifa, Israel

    R. Finkelstein, O. Eluk & T. Mashiach

  2. Department of Orthopaedic Surgery, Rambam Medical Center, 31096, Haifa, Israel

    D. Levin, B. Peskin, G. Nirenberg, S. Karkabi & M. Soudri

  3. The Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel

    R. Finkelstein & M. Soudri

Authors
  1. R. Finkelstein
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  2. O. Eluk
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  3. T. Mashiach
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  4. D. Levin
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  5. B. Peskin
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  6. G. Nirenberg
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  7. S. Karkabi
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  8. M. Soudri
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Corresponding author

Correspondence to R. Finkelstein.

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The authors declare no conflict of interest.

Additional information

A correction to this article is available online at https://doi.org/10.1007/s12306-017-0508-6.

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Finkelstein, R., Eluk, O., Mashiach, T. et al. Reducing surgical site infections following total hip and knee arthroplasty: an Israeli experience. Musculoskelet Surg 101, 219–225 (2017). https://doi.org/10.1007/s12306-017-0471-2

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  • DOI: https://doi.org/10.1007/s12306-017-0471-2

Keywords

  • Surgical site infections
  • Infection control
  • Total joint arthroplasty
  • Hip arthroplasty
  • Knee arthroplasty
  • Antibiotic prophylaxis