Article

Over the decades, improvements in surgery and
perioperative routines have reduced the incidence of deep infections after total
hip arthroplasty (THA).
There is, however, some evidence to suggest that the
incidence of infection is increasing again. We assessed the risk of revision due
to deep infection for primary THAs reported to the Norwegian Arthroplasty
Register (NAR) over the period 1987-2007. METHOD: We included all primary
cemented and uncemented THAs reported to the NAR from September 15, 1987 to
January 1, 2008 and performed adjusted Cox regression analyses with the first
revision due to deep infection as endpoint. Changes in revision rate as a
function of the year of operation were investigated. RESULTS: Of the 97,344
primary THAs that met the inclusion criteria, 614 THAs had been revised due to
deep infection (5-year survival 99.46%). Risk of revision due to deep infection
increased throughout the period studied. Compared to the THAs implanted in
1987-1992, the risk of revision due to infection was 1.3 times higher (95%CI:
1.0-1.7) for those implanted in 1993-1997, 1.5 times (95% CI: 1.2-2.0) for those
implanted in 1998-2002, and 3.0 times (95% CI: 2.2-4.0) for those implanted in
2003-2007. The most pronounced increase in risk of being revised due to deep
infection was for the subgroup of uncemented THAs from 2003-2007, which had an
increase of 5 times (95% CI: 2.6-11) compared to uncemented THAs from 1987-1992.
INTERPRETATION: The incidence of deep infection after THA increased during the
period 1987-2007. Concomitant changes in confounding factors, however, complicate
the interpretation of the results.

Langue : ANGLAIS