DOS Afhandlingsdatabase
Titel på arbejdet | Prosthetic joint infection after total hip arthroplasty; Previous infection, seasonal variation and risk of second revision following prosthetic joint infection |
---|---|
Navn | Rajzan Joanroy |
Årstal | 2024 |
Afdeling / Sted | Ortopædkirurgisk afdelinge, Vejle |
Universitet | Syddansk Universitet |
Subspeciale |
|
Abstract / Summary | The hip joint is a ball-and-socket joint connecting the femur to the pelvis, allowing for a wide range of motion and supporting weight-bearing activities. It is covered with articular cartilage that cushions and facilitates smooth movement. However, osteoarthritis (OA) of the hip, a degenerative condition, can occur in the aging population. OA involves the gradual breakdown of cartilage, narrowing the joint space, and causing pain, stiffness, and reduced mobility. Various factors, including age, obesity, trauma, and genetics, contribute to the development of OA. While OA cannot be cured, it can be managed through painkillers, weight loss, physical therapy, and lifestyle modifications. When conservative treatments fail, total hip arthroplasty (THA) may be recommended. THA, also known as total hip replacement, involves replacing the damaged hip joint with an artificial prosthesis. The history of THA dates back to the late 19th century, with significant advancements occurring in the 1960s, thanks to Sir John Charnley's pioneering work. Today, THA is a common and successful orthopedic procedure performed worldwide, benefiting patients with conditions like OA, fractures, and hip diseases. However, it is not without risks, as complications can necessitate revision surgery. Revision surgery is performed to address complications, such as prosthetic joint infection (PJI), which can have serious implications for patients and lead to increased healthcare costs. Diagnosing PJI is challenging due to its variable clinical manifestations. Various tests, including cultures of intraoperative biopsies and synovial fluid analysis, have been used to diagnose PJI. Revision surgery due to PJI leads to prolonged hospital stays, increased re-admissions, and potential complications, including antibiotic-related side effects. Studies have shown varying outcomes regarding the risk of death after PJI revision, with further research needed for conclusive results. The incidence of PJI is on the rise, likely due to factors like an aging population and improved diagnostics. Identifying modifiable risk factors and taking preventive measures before planned THA is essential to reduce the risk of PJI. The impaction of general previous infection is important to investigate as some patients might be more prone to infections and preventive measures and strategies must be developed to reduce the risk of PJI. One potentially overlooked factor is the seasonality of PJI rates. Some studies have suggested a link between higher PJI rates during the summer, possibly due to climate-related factors. However, more research with larger sample sizes and comprehensive analyses is needed to fully understand this association. In conclusion, PJI is a serious complication following THA, with significant implications for patients and healthcare systems. Understanding and mitigating risk factors, including potential seasonality, is crucial to improving patient outcomes and reducing the burden of PJI on healthcare resources. This PhD study aims to contribute to this knowledge by analyzing extensive data from Danish health registers, offering valuable insights into PJI risk factors and their impact on patient outcomes following primary THA. Study I: Study II: Study III: |