ArticleBMC musculoskeletal disorders2017
Patient and surgical factors affecting procedure duration and revision risk due to deep infection in primary total knee arthroplasty.
Article in BMC musculoskeletal disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Hospital volume-outcome relationship in total knee arthroplasty: a systematic review and dose-response meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Pooled it
- Operative Time and Risk of Surgical Site Infection and Periprosthetic Joint Infection: A Systematic Review and Meta-Analysis.The Iowa orthopaedic journal · 2022Pooled it
- Optimizing Daily Surgical Scheduling Improves Operative Time Consumption: A Retrospective Study.Arthroplasty today · 2026Article
- A Retrospective Cohort Study of Early Prosthetic Joint Infections at a US Academic Medical Center (2014-2023).Cureus · 2025Article
- Leveraging machine learning for duration of surgery prediction in knee and hip arthroplasty - a development and validation study.BMC medical informatics and decision making · 2025Article
- Coronal plane deformity in total knee arthroplasty is associated with increased operative time and disposition to skilled nursing facility.Archives of orthopaedic and trauma surgery · 2024Article
- Intraoperative and Postoperative Outcomes of Patients Undergoing Total Knee Arthroplasty With Prior Anterior Cruciate Ligament Reconstruction: A Matched Cohort Analysis.Arthroplasty today · 2024Article
- Greater Risk of Periprosthetic Joint Infection Associated with Prolonged Operative Time in Primary Total Knee Arthroplasty: Meta-Analysis of 427,361 Patients.Journal of clinical medicine · 2024Review
- Influence of Surgery Preparation Time on Patient Outcomes.Journal of nursing management · 2024Article
- Staged Extra-Articular Deformity Correction in the Setting of Total Knee Arthroplasty.Arthroplasty today · 2023Article
- Incidence, Microbiological Studies, and Factors Associated With Prosthetic Joint Infection After Total Knee Arthroplasty.JAMA network open · 2023Article
- Article
- Knee Arthrodesis: An Analysis of Surgical Risk Factors and Complications Using a National Database.Arthroplasty today · 2023Article
- Associations of parecoxib and other variables with recovery and safety outcomes in total knee arthroplasty: insights from a retrospective cohort study.Frontiers in surgery · 2023Article
- Impact of resident involvement on complication rates in revision total knee arthroplasty.Journal of Taibah University Medical Sciences · 2022Article
- Comparison of Operative Times in Primary Bilateral Total Knee Arthroplasty Performed by a Single Surgeon.Journal of clinical medicine · 2022Article
- Total Knee Arthroplasty, All-in-One versus Four-in-One Femoral Cutting Jig System: A Comparison Study.Advances in orthopedics · 2022Article
- Risk factors for prosthetic joint infections following total hip arthroplasty based on 33,337 hips in the Finnish Arthroplasty Register from 2014 to 2018.Acta orthopaedica · 2021Article
- Techniques and Strategies to Optimize Efficiencies in the Office and Operating Room: Getting Through the Patient Backlog and Preserving Hospital Resources.The Journal of arthroplasty · 2021Article
- Analysis of the relationship between surgeon procedure volume and complications after total knee arthroplasty using a propensity-matched cohort study.BMJ surgery, interventions, & health technologies · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
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Abstract
backgroundThe aim of this study was to assess which patient and procedure factors affected both the risk of infection as well as procedure duration. Additionally, to assess if procedure duration affected the revision risk due to deep infection in total knee arthroplasty (TKA) patients and in a subgroup of low-risk patients.
methods28,262 primary TKA with 311 revisions due to deep infection were included from the Norwegian Arthroplasty Register (NAR) and analysed from primary surgery from 2005 until 31st December 2015 with a 1 and 4 year follow up. The risk of revision due to deep infection was calculated in a multivariable Cox regression model including patient and procedure related risk factors, assessing Hazard Ratio (HR) with 95% confidence interval (CI).
resultsMultivariate analysis showed statistically significant associations with revision due to deep infection and increased procedure duration for male patients, ASA3+ (American Society of Anesthesiologists) and perioperative complications. Procedure duration ≥110 min (75 percentile) had a higher risk of deep infection compared to duration <75 min (25 percentile), in the unadjusted analysis (HR = 1.8, 95% CI 1.3-2.5, p = 0.001) and in the adjusted analysis (HR = 1.5, 95% CI 1.0-2.1, p = 0.03). For low-risk patients, procedure duration did not increase the risk of infection.
conclusionMale patients, ASA 3+ patients and perioperative complications were risk factors both for longer procedure duration and for deep infection revisions. Patients with a high degree of comorbidity, defined as ASA3+, are at risk of infection with longer procedure durations. The occurrence of perioperative complications potentially leading to a more complex and lengthy procedure was associated with a higher risk of infection. Long procedure duration in itself seems to have minor impact on infection since we found no association in the low-risk patient.
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