Risk factors for infection in patients undergoing knee arthroscopy: a systematic review and meta-analysis

The primary aim of this study was to determine the risk of infection after knee arthroscopy and to evaluate the risk factors for surgical site infection (SSI). The PubMed/Medline, Embase and Cochrane Library databases were systematically searched, as were the reference lists of previous systematic reviews and meta-analysis manual studies. A random-effects model was used to calculate the estimated pooled odds ratio (OR). A total of 38,321 potential articles met the initial inclusion criteria. After a review of the titles, abstracts and full texts, the remaining 41 articles were included in the final analysis. We identified 9,089,578 patients who underwent knee arthroscopy in 41 articles. High-quality (class I) evidence showed that autografts (cruciate ligament reconstruction) (OR, 2.66;95% CI, 1.84–3.86) or high procedure complexity (OR, 2.02; 95% CI, 1.69–2.43) had a higher risk of infection, while medium-quality (class II or class III) evidence showed that obesity (body mass index ≥30 kg/m²) (OR, 1.27; 95% CI, 1.08–1.49) or male (OR, 1.52; 95% CI, 1.32–1.75) or diabetes (OR, 1.71; 95% CI, 1.36–2.14) or tobacco use (OR, 1.65; 95% CI, 1.38–1.97) or preoperative steroid use (OR, 3.41; 95% CI, 2.10–5.54) had a higher risk of infection. The meta-analysis showed that there was no association between age or antibiotic prophylaxis and infection incidence. The meta-analysis showed that significant risk factors for infection after knee arthroscopy included obesity, male sex, diabetes, tobacco use, high procedure complexity, graft type, and preoperative steroid use.