Background
Hip replacement therapies are generally effective in increasing mobility and reducing pain. In England, for example, there are more than 40000 total jip replacements each year, and the numbers continue to rise (Zhu et al., 2016). In addition, more than 50000 patients with proximal femur fractures, most of which need a hemiarthroplasty, are admitted to the hospital each year. However, the risks of mortality in patients who have undergone a total hip replacement and have developed infections have a higher mortality and morbidity rate compared to those who do not develop infection (Hessels et al., 2016). Generally, total hip replacement enhances mortality risk. However, infection following a complete knee replacement is a rare complication (Moore et al., 2015). Deep prosthetic joint infection is developed by 1% of individuals with hip replacement.
Final Picot Question
Amongst post-op hip replacement patients, do those who have developed an infection verse those who don't develop an infection have higher overall mortality and morbidity?
Delegate your assignment to our experts and they will do the rest.
“ What is the duration of recovery for patients who have gone through total hip replacement who developed a postoperative infection as opposed to those who did not?”
P : “patients who have gone through total hip replacement”
I : “developed infection”
C : “as opposed to those who did not develop a post-operative infection”
O : “overall mortality and morbidity”
Search Strategy:
Databases: PubMed, CINAHL, Cochrane,
Keywords: total hip replacement, infection, postoperative, duration of recovery
Limits & Filters: published in the last 5 years, English only, full free text.
Search Results
Hip replacement is an effective procedure and intervention to improve mobility, reduce pain, and improve patients' quality of life with hip fractures, degeneration or disability, and patients with arthritis. The majority of total hip replacement procedures are done on patients 65 years or older. Surgical site infections (SSIs) in these patients lead to an increase in the patients' mortality rates and hence poor life outcomes. However, this is just one example of post-operative complications and hence the necessity to guide strategies of risk-reduction.
According to a CDC report, the rate of surgical site infections following hip operations with a prosthetic implant per 100 operations ranged from 0.67 to 2.40. Besides, most of SSIs are as a result of orthopedic operations. While the incidence of SSIs in patients who have undergone the hip surgical procedure is low at 0.8%, they are higher in patients who have undergone hip revision process than those who have undergone hip replacement process. The greater risk of SSI in individuals who have undergone hip replacement is mixed with age. The risk may be higher in younger patients due to underlying etiology for operation such as congenital malformation, osteoarthritis, and hip fracture. The incidence may also be greater due to anatomic differences with older patients, such as joint space width.
References
Hessels, A. J., Agarwal, M., Liu, J., & Larson, E. L. (2016). Incidence and Risk Factors for Health-Care Associated Infections after Hip Operation. Surgical Infections , 17 (6), 761-765. https://doi.org/10.1089/sur.2016.062
Moore, A. J., Blom, A. W., Whitehouse, M. R., & Gooberman-Hill, R. (2015). Deep prosthetic joint infection: a qualitative study of the impact on patients and their experiences of revision surgery. BMJ Open , 5 (12). https://doi.org/10.1136/bmjopen-2015-009495
Zhu, M., Ravi, S., Frampton, C., Luey, C., & Young, S. (2016). New Zealand Joint Registry data underestimates the rate of prosthetic joint infection. Acta orthopaedica , 87 (4), 346-350. https://doi.org/ 10.3109/17453674.2016.1171639
