Periprosthetic joint infections: a 20 years retrospective epidemiological study in a single european accademic hospital

Introduction: Periprosthetic Joint infections (PJIs) still represent one of the most challenging complications in orthopaedic reconstructive surgery. The aim of our work is to present a retrospective observational analysis with 20 years of follow up of PJIs referred to a single center equipped with a regional referral infectious diseases department. Materials and methods: 368 case of deep PJIs following a primary or revision hip and knee arthroplasty procedure referred to our center between January 1996 and December 2016 were included in the study. Criteria of inclusion in the study was a primary PJI entirely managed in our hospital. We collected demographic data, risk factors, microbiology (identification pathogenic agent), previous surgical treatments, type of implant, diagnostic criteria of infection, type of infection and medical or surgical treatments performed in our institution Results: A total of 200 (54,3%) infection occurs in hip arthroplasty and 168 (45,7%) in knee arthroplasty. Mean age was 64,7 years. The majority were late infections (58,8%). Respectively polymicrobial infections was identified in 83 (22,6%) cases and in 54 (14,7%) patients no isolation was possible. S. Aureus was the most frequently identified pathogen. The major risk factors were hypertension in 254 (69,1%), cardiovascular diseases in 167 (45,7%), obesity in 97 (26,5%) and diabetes mellitus in 92 (25%). Discussion: Epidemiological analysis of PJI in our hospital which collects data relating to the last 20 years, has permitted to obtain a summary of our scenario. Ideal PJI management should include an accurate patient history considering carefully risk factors, patients conditions, and previous surgical procedures ideally in a multispecialist enviroment.