![]() 8, 9 Furthermore, patients with SSIs have been found to have higher mortality rates compared with patients without SSIs, as well as extended time spent in the hospital and higher costs of medical care. 8 Although the reported infection rates of periarticular knee fractures are highly variable, understanding the frequency with which infectious adverse outcomes occur is important to orthopedic surgeons for the management and prevention of adverse outcomes, such as unsatisfactory outcomes for the affected patient and possible loss of function in the affected region. Recent literature indicates that the rate of postoperative surgical site infection (SSI) may range from 13% to 88% for tibial plateau fractures, 2 3% to 17% for distal femur fractures, 3 2% to 10% for patellar fractures, 4 - 7 and 3% to 45% for proximal tibia fractures. 1 Managing these fractures can be challenging, and adverse outcomes can include nonunion, malunion, heterotopic ossification, arthrofibrosis, compartment syndrome, and infection among others. The goals for treating fractures around the knee include satisfactory restoration of mechanical alignment, anatomical reduction of the articular surface, and stable fixation to allow early motion of the knee. Efforts should be made to elevate the quality of research conducted not only in this subject but also in orthopedic surgery as a whole. Surgeons managing these injuries should be vigilant when wounds are not pristine. Sixty-two studies (53.0%) in the sample received a Coleman Methodological Score of poor (<50 points).Ĭonclusions and Relevance Deep SSIs occurred in nearly 6% of periarticular knee fracture repairs, and 2.4% of SSIs were associated with septic arthritis. The 2 most commonly reported bacteria were methicillin-resistant Staphylococcus aureus, found in 67 SSIs, and methicillin-susceptible S aureus, found in 53 SSIs. Among studies that included information on septic arthritis, 38 of 1567 patients (2.4%) experienced septic arthritis. ![]() Among 11 432 patients included in analysis, 653 patients (5.7%) experienced deep SSIs, most commonly among patients with proximal tibia fractures (56 of 872 patients ). Results Of 6928 articles screened, 117 articles met inclusion criteria and were included in analysis. ![]() The secondary outcomes were the overall prevalence of septic arthritis, risk factors associated with deep SSI, and the most commonly cultured bacteria specimens found periarticular knee infections. Main Outcomes and Measures The primary outcome was overall prevalence of deep SSI after periarticular knee fracture repair. Data analyses were conducted in October 2018. Comprehensive Meta-Analysis software was used for the pooling of data, using either random-effects or fixed-effects models, with respect to the degree of statistical heterogeneity present. Data were extracted by multiple investigators. Risk factors that were associated with increased the risk of deep SSI were also examined.ĭata Extraction and Synthesis This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Study Selection Eligible studies had to specifically report deep SSI rates and include fractures in the distal femur, patella, tibial plateau, or proximal tibia. Objective To examine the prevalence of deep SSI and the rate of septic arthritis after surgical repair of fractures around the knee.ĭata Sources The electronic databases MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from their inception to July 1, 2018. Recent literature indicates that the rate of periarticular knee surgical site infection (SSI) may range from 2% to 88% depending on the fracture site. Importance Surgical management of periarticular knee fractures can be challenging, and adverse outcomes may be severe.
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