Abstract
Introduction Periprosthetic infection (PPI) is one of the most serious complications in total
knee arthroplasty (TKA). Despite this, there is little Chilean literature regarding
this pathology.
Objectives To determine the incidence, comorbidities, isolated microorganisms and their antibiotic
susceptibility, morbidity, and mortality in patients with PPI.
Materials and Methods A descriptive and retrospective study in patients operated between 2001 and 2020
for gonarthrosis, with a primary TKA, in the same health center, with at least 1 year
of follow-up. Patients operated on in other centers or with incomplete clinical records
were excluded. Comorbidities, isolated microorganisms, antibiotic susceptibility,
and survival were recorded through a systematic search of the clinical records of
patients with PPI. Descriptive statistics were used to present the data.
Results We included 544 TKAs, 8 (1.47%) of which presented PPI, and the patients had an average
age at presentation of 66 years (±5.7 years) and an average body mass index (BMI)
of 30.3 (±4, 5) kg/m2. The median time of presentation of the PPI was of 411 (±1,034) days. The main comorbidities
recorded were arterial hypertension in 5 (62.5%), smoking in 4 (50%) cases, and dyslipidemia
in 4 (50%) cases. In total, 5 (62.5%) patients presented polymicrobial etiology, and
in 3 (37.5%), a single microorganism was isolated. The main isolated agents were Staphylococcus aureus and coagulase-negative Staphylococcus, both multidrug-resistant, in 6 (75%) and 3 (37.5%) patients respectively. All patients
received three doses of cefazolin as surgical prophylaxis. A sensitivity of 100% to
vancomycin and rifampicin (12/12 cultures), and a resistance of 83.4% to ciprofloxacin
(4/9 cultures) were described. Overall, 2 (25%) patients died 3 years after the TKA,
due to causes unrelated to PPI. There were no cases of infectious relapse after the
review.
Conclusion An incidence of 1.47% (8 cases) of PPI was found. All patients with PPI presented
some presurgical comorbidity. The main microbiological agents identified were multidrug-resistant
and susceptible to vancomycin and rifampicin.
Keywords
periprosthetic infection - knee - microorganisms - antibiotic resistance
