Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta-analysis: Risk factors for PJI following TJA

To identify risk factors for periprosthetic joint infection following primary total joint arthroplasty, a systematic search was performed in Pubmed, Embase and Cochrane library databases. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Patient characteristics, surgical-related factors and comorbidities, as potential risk factors, were investigated. The main factors associated with infection after total joint arthroplasty (TJA) were male gender (OR, 1⋅48; 95% CI, 1.19–1.85), age (SMD, −0⋅10; 95% CI, −0.17–−0.03), obesity (OR, 1⋅54; 95% CI, 1⋅25–1⋅90), alcohol abuse (OR, 1⋅88; 95% CI, 1⋅32–2⋅68), American Society of Anesthesiologists (ASA) scale> 2 (OR, 2⋅06; 95% CI, 1⋅77–2⋅39), operative time (SMD, 0⋅49; 95% CI, 0⋅19–0⋅78), drain usage (OR, 0⋅36; 95% CI, 0⋅18–0⋅74), diabetes mellitus (OR, 1⋅58; 95% CI, 1⋅37–1⋅81), urinary tract infection (OR, 1⋅53; 95% CI, 1.09–2.16) and rheumatoid arthritis (OR, 1⋅57; 95% CI, 1⋅30–1⋅88). Among these risk factors, ASA score> 2 was a high risk factor, and drain usage was a protective factor. There was positive evidence for some factors that could be used to prevent the onset of infection after TJA.