ABSTRACT
There are many studies whose results reveal possible risk factors for developing an infection after a total knee arthroplasty (TKA). The objective of this study is to analyse the risk factors that depend on the hospital and, especially, if the patellar replacement influences the appearance of periprosthetic infection. A retrospective study was performed, where data from the electronic registry of patients of people over 18 and who had undergone TKA, between the years 2015 and 2018, were reviewed. Dependent variables on the patients and the health care system were collected. The possible associations between the factors and the appearance of infection after TKA were studied using univariate and multivariate regression analyses. A total of 907 primary knee arthroplasties were included in the study. Those patients who had their patella replaced had a significantly higher risk of developing an infection (OR 2.07; 95% confidence interval 1.01-6.31). Likewise, patients who underwent surgery by surgeons with more than 10 years of experience were more than twice as likely to become infected than those operated on by younger surgeons (OR 2.64; 95%CI 1.01-6.97). Male patients were also found to be three times more likely to be infected than women (OR 2.99; 95%CI 1.32-5.74). Those interventions that were longer had a higher risk of infection. The same happened with patients who stayed in the hospital for a longer period of time. The rest of the variables did not show statistically significant results. In this study, it was found that the replacement of the patella may be a factor of infection, but it should be corroborated with randomized clinical trials. Furthermore, patients who underwent longer surgeries or those with prolonged hospital stays should be closely monitored to detect infection as soon as possible and establish the most appropriate treatment.
ABSTRACT
Objetivo: La fractura luxación central bilateral de cadera es una lesión muy infrecuente. El objetivo se basa en exponer nuestra experiencia y resaltar la importancia de su diagnóstico precoz por la elevada mortalidad que supone el retraso del mismo. Material y métodos: En este artículo se expone el caso de un varón de 68 años que ingresó en nuestro hospital tras presentar una fractura-luxación central de ambas caderas tras crisis convulsiva. Resultados: En este caso, se decidió tratamiento conservador al tratarse de un paciente pluripatológico con alto riesgo quirúrgico y desenlace fatal. Conclusiones: En la literatura consultada, el tratamiento de elección es la reducción abierta y fijación interna, sin embargo, la mayoría de los pacientes tenían grandes morbilidades optándose por tratamiento conservador mediante tracciones transesqueléticas y vigilancia estrecha del sangrado.(AU)
Objective: Bilateral-central luxation hip fracture is an infrequent injury. Our aim is to present our experience highlighting the value of an early diagnosis whose delay causes a high mortality.Material and methods: This article sets out a 68-year-old man case who was admitted to our hospital for evaluation. A luxation-fracture in both hips diagnosis was made following a generalized seizure.Results: In this case, it was decided a conservative treatment addressing his pluripatological condition with high surgical associated risk and fatal ending.Conclusions: According to bibliography, the election treatment is an open reduction with an internal fixation. However, due to the fact that most of patients had high morbidities, a conservative treatment based on transeskeletal tractions along with a close monitoring of bleeding was elected.(AU)
