Observational and retrospective comparison of incidence or prevalence of all risk factors described in the literature. These factors have been classified according to the period of risk in: epidemiologic; pre, intra and postoperative; and distant infections.
Pearson was used for comparison of qualitative variables and ANOVA for quantitative ones.
Epidemiologic characteristics: female gender, post-traumatic osteoarthritis (17% vs 3%). On the contrary, primary osteoarthritis is a “protective” factor. Preoperative conditions: previous surgery in the same hip (60% vs 6%), obesity (BMI>
30) (9% vs 1%), chronic therapy with glucocorticoids (13% vs 0%), immunosuppressive treatments, chronic liver diseases (20% vs 2%), alcohol addiction (13% vs 0%) and intravenous drug abuse. Patients in this case-control did not present a significant difference in the prevalence of diabetes (a recognised risk factor for spine and knee surgery) or rheumatoid arthritis. Intraoperative facts: a prolonged surgical time is the only significant risk factor (133 min vs 98 min), but differences were not found in the amount of bleeding, need for transfusion or intraoperative fractures. Postoperative events: secretion of the wound longer than 10 days (46% vs 8%), palpable deep haematoma (27% vs 1%), dislocation of the prosthesis (40% vs 6%), and need for new surgery in the hip (21% vs 1%). Distant infections (risk for haematogenous seeding): deep cutaneous (30% vs 8%), upper and lower urinary tract (36% vs 2%), pneumonias and bronchopneumonias (23% vs 5%), and diverse abdominal focus (14% vs 3%). On the contrary, significant differences were not found in the prevalence of severe oral or dental infections.
to control and minimize these risk factors when present when this is not possible not possible, to implement additional prophylactic measures.
