Wound infection in hip and knee arthroplastyW. J. Gaine, FRCS, Specialist Registrar; N. A. Ramamohan, FRCS, Specialist Registrar; N. A. Hussein, FRCS, Specialist Registrar; M. G. Hullin, MD, FRCS, Consultant Orthopaedic Surgeon; and S. W. McCreath, FRCS, Consultant Orthopaedic SurgeonDepartment of Orthopaedics, Southern General Hospital, Govan Road, Glasgow GS1 4TF, UK. Correspondence should be sent to Mr W. J. Gaine at 1 Brandon Avenue, Northenden, Manchester M22 4BF, UK. We have studied prospectively the outcome of wound discharge in patients after arthroplasty of the hip and knee. Over a period of 3.5 years 530 primary arthroplasties were carried out in one hospital. Postoperative wound infections developed in 82. At a mean follow-up of two years a comparison was made between these patients and 82 with healthy wounds, in terms of symptoms and signs of deep infection. There was an incidence of 1.1% of early deep infection, within six weeks in all cases. The rate of ‘superficial’ infection was 17.3% in the hips, 10.5% in the knees and 14.3% in total. At a mean follow-up of 26 months, there were no significant differences between the patients with infected wounds and a matched group of patients with healthy wounds in terms of the ESR, level of C-reactive protein, white cell count and radiological scores, but clinical scores were significantly worse in the patients with infected knees (p < 0.05). The length of stay was also significantly longer in this group (mean 14.6 days in the healthy wound group, 19 days in the problem group; p < 0.005). There was, however, no convincing evidence that these wound infections led to deep infection and early revision in the early to medium follow-up period. A larger and longer prospective trial would be necessary to shed more light on this potential problem. This article has been cited by other articles:
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