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ARE WE INFECTING THE HIPS AND KNEES?

Good Hope Hospital NHS Trust

Purpose of the study: To ascertain, the Post-operative Joint Infection rates in the Department during 2004.

Methods used and the results: Details of 607 patients were collected. Females were 379(62%) whereas males were 228(38%). Less than 65 years were 133(22%), between 66 and 80 years were 319(53%) and above 80s figure was 155(26%). Total of 197 Primary Hip Arthroplasties (THR) and 190 Knee Arthroplasties (TKR) had been performed. Hip Hemiarthroplasties totalled 137. All the demographic indicators were looked in detail for gender and age range distribution. Revision THRs were 66 whereas 17 were Revision TKRs.

For the purpose of this study, the Revision Arthroplasties were excluded.

Amongst Total Joint Arthroplasties, though 10 patients out of 387 had provided positive results for STAA (Staph. Aureus) from swab specimens, none of the patients developed deep infection. But out of 8, who showed MRSA growth from wound swabs, one patient developed deep infection and needed conversion to Girdlestone procedure. Thus the positive results for wound specimens were 18(4.65%), while the re-operation rate was 1(0.26%).

Conclusion: It is interesting to note that MRSA was prevalent in above 80s while STAA was more common in under 80s. Majority of MRSA positive results were after 30 days while that for the STAA it was before 30 days post-operatively. Of the 18 ‘infected’ cases; Consultants and SAS surgeons had performed 9 cases each.

Amongst 137 Hip Hemiarthroplasties, 25 showed positive growths, 7 for STAA and 18 for MRSA. None needed re-operation.

Interesting revelations on misconceptions are revealed!

Correspondence should be addressed to Mr Bimal Singh, c/o BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE