Soft-tissue thickness radiographic measurement: a marker to evaluate acute periprosthetic joint infection risk in total hip replacement.

IF 1.8 Q3 INFECTIOUS DISEASES Journal of Bone and Joint Infection Pub Date : 2021-06-04 eCollection Date: 2021-01-01 DOI:10.5194/jbji-6-211-2021
Laura Rey Fernández, Francesc Angles Crespo, Silvia María Miguela Álvarez, Martí Carles Bernaus-Johnson, Agustí Bartra Ylla, Lluís Font-Vizcarra
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引用次数: 2

Abstract

The objective of our study was to evaluate the association between acute periprosthetic joint infection (APJI) and radiographic measurement of soft-tissue thickness in elective total hip replacement surgery. A case-control study was conducted to compare the soft-tissue thickness radiographic measurement (SRM) at the hip in patients diagnosed with APJI based on Tsukayama et al. (2003) criteria after total hip replacement with patients that were not infected, at a single institution from 2013 to 2019. To minimize selection bias, each case was matched with two controls using the following methodology: patients of the same sex, with an age variation of ± 5 years, and nearest in surgery date to the cases were selected. All postoperative radiographs were performed in the first 24 h after total hip arthroplasty (THA) surgery as it is protocolized in our institution. Soft-tissue thickness radiographic measurement was defined as the distance from the tip of the greater trochanter to the skin following a perpendicular line to the femoral diaphysis in postoperative anteroposterior hip radiographs. In total, 78 patients were included (26 cases and 52 controls). The SRM median of the cases was 76.19 mm (SD: 26.518) and 53.5 mm (SD: 20.47) in controls. A multivariate logistic regression model showed an independent association between APJI and SRM (odds ratio (OR)  =  1.033, 95 % confidence interval (CI) 1.007-1.059, p = 0 .012). Patients with an SRM greater than 60 mm had a 7-fold increase in the odds of APJI (OR  =  7.295, 95 % CI  =  2.364-22.511, p < 0 .001). The results of our study suggest an association between large SRM at the hip and the risk of APJI in patients with primary total hip arthroplasty. SRM may be a helpful and easy tool for evaluating the risk of APJI before elective primary total hip replacement surgery.

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软组织厚度x线测量:评估全髋关节置换术中急性假体周围关节感染风险的标志。
本研究的目的是评估选择性全髋关节置换术中急性假体周围关节感染(APJI)与x线测量软组织厚度之间的关系。2013年至2019年,在一家机构进行了一项病例对照研究,比较了根据Tsukayama等(2003)标准诊断为APJI的患者在全髋关节置换术后与未感染患者的髋关节软组织厚度放射测量(SRM)。为了尽量减少选择偏倚,采用以下方法将每个病例与两个对照进行匹配:选择性别相同、年龄相差±5岁、手术日期与病例最接近的患者。所有的术后x线片都是在全髋关节置换术(THA)手术后的第一个24 小时内进行的,因为这是我们机构的规定。软组织厚度x线测量被定义为术后髋关节前后位x线片上从大转子尖端到皮肤沿股骨干垂直的距离。共纳入78例患者(26例和52例对照)。病例的SRM中位数为76.19 mm (SD: 26.518),对照组为53.5 mm (SD: 20.47)。多因素logistic回归模型显示APJI与SRM独立相关(比值比(OR) = 1.033,95 %置信区间(CI) 1.007-1.059, p = 0.012)。SRM大于60 mm的患者发生APJI的几率增加7倍(OR = 7.295,95 % CI = 2.364-22.511,p 0.001)。我们的研究结果表明,髋关节大SRM与原发性全髋关节置换术患者APJI风险之间存在关联。SRM可能是评估选择性原发性全髋关节置换术前APJI风险的一种有用且简单的工具。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
29
审稿时长
12 weeks
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