Periprosthetic Knee Infection: Ten Strategies That Work

of PJI should be mandatory for each surgeon that is involved in knee arthroplasty. Optimization of modifiable variables that may influence this risk is also critical. A recent study by Namba et al. 1) evaluated 56,216 total knee arthroplasty (TKA) surgeries. The study found an incidence of deep infection of 0.72% (404/56,216). The risk factors for infection were body mass index (BMI) of 35 (hazard ratio [HR], 1.47), diabetes mellitus (HR, 1.28), male sex (HR, 1.89), an American Society of Anesthesiologists (ASA) score of 3 (HR, 1.65), osteonecrosis (HR, 3.65), and posttraumatic arthritis (HR, 3.23). Hispanic race was a protective factor (HR, 0.69), the use of antibiotic irrigation (HR, 0.67), a bilateral procedure (HR, 0.51), and a lower annual hospital volume (HR, 0.33). Surgical risk factors included quadriceps-release exposure (HR, 4.76), and the use of antibiotic-laden cement (HR, 1.53). Operative time was a risk factor, with a 9% increased risk per fifteen-minute increments. Although some risk factors found in this study are debatable, the study highlights some of the important predisposing factors for infection.