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JRPMS Vol 3, No 3, September 2019, p.87-95

doi: 10.22540/JRPMS-03-087


Review Article

Risk factors for periprosthetic joint infection following total hip and knee arthroplasty

Argyris Costa Hadjimichael1,2, Athanasios Fotios Foukas1, Athanasios Antonopoulos1, Olga Savvidou3, Panayiotis Papagelopoulos3

  1. 3rd Orthopaedic Department, KAT Hospital, Athens, Greece
  2. Postgraduate MSc program “Metabolic Bone Diseases”, National and Kapodistrian University of Athens, Medical School
  3. 1st Department of Orthopedic Surgery, National and Kapodistrian University of Athens, Medical School, ATTIKON University Hospital, Athens, Greece

Keywords: Osteoarthrosis, Total hip replacement, Total knee replacement, Periprosthetic infections, Risk factors


Osteoarthrosis is a common degenerative and progressive disease, involving the articular cartilage as well as the subchondral bone and the soft tissues in the hip and knee. The incidence of hip and knee osteoarthrosis has increased over the last twenty years and is expected to increase even further. Approximately, 40% of men and 47% of women over 65 years old suffer from symptomatic osteoarthrosis that eventually requires surgical treatment by an orthopedic surgeon. In 2010 around 2.5 million patients were operated for total hip replacement and around 4.7 people with knee osteoarthrosis had a total knee replacement in the United States of America. Acute periprosthetic joint infection, with Staphylococcus aureus being the most common and aggressive pathogen is a very threatening complication for the whole health status of the patient. The need for revision procedures due to periprosthetic hip infection is expected to be doubled in 2026 and is already doubled due to periprosthetic knee infection in 2015.The risk factors for hip and knee periprosthetic joint infections appear in the preoperative period, as well as intraoperatively and continue to be harmful both in the postoperative period and after the patient’s discharge from the hospital. The aim of this article is to present the variety of risk factors, associated with periprosthetic infections after total hip and knee replacements. Many risk factors can be controlled with the use of specific preventive and therapeutic interventions by orthopedic surgeons.