The incidence of detectable bacterial contaminated primary joint arthroplasties and periprosthetic joint infection: a systematic review and meta-analysis.

IF 4.6 2区医学 Q1 ORTHOPEDICS

Efort Open Reviews Pub Date : 2026-06-01 DOI:10.1530/EOR-2025-0074

Maarten M Bruin, Rob G H H Nelissen, Jan W Schoones, Mark G J de Boer, Ruud L M Deijkers, Bart G C W Pijls

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引用次数: 0

Abstract

Purpose: The association between positive intraoperative cultures during primary joint arthroplasty and periprosthetic joint infections (PJIs) remains controversial. This systematic review and meta-analysis examines the association between intraoperative contamination and complications such as PJIs and revision rates.

Methods: We searched PubMed, Web of Science, Cochrane, Emcare (OVID), Embase (OVID), MEDLINE, Academic Search Premier and the references of included studies evaluating the outcome of contaminated and non-contaminated primary joint arthroplasties. This systematic review and meta-analysis was performed according to the PRISMA statement, and the research protocol was uploaded a priori at Open Science Framework. Two researchers independently reviewed all the titles, abstracts and full texts, and extracted the available data. Study eligibility criteria were primary joint arthroplasty with cultures taken during initial procedure and documentation of PJIs and revision rates.

Results: The search yielded 26 studies after inclusion and exclusion criteria, involving 4,556 primary joint arthroplasties. The overall incidence of bacterial contamination was 24.7% (95% CI: 19-30%). The incidence of PJIs was 2.0% (95% CI: 1.1-2.8%) in the contaminated group versus 1.0% (95% CI: 0.6-1.4%) in the non-contaminated group, with a pooled adjusted risk ratio (RR) of 2.0 (95% CI: 1.3-3.1). The pooled analysis revealed an increased risk of contaminated joint arthroplasties for revision for any reason, with a pooled RR of 1.86 (95% CI: 1.14-3.03).

Conclusion: This systematic review and meta-analysis suggests intraoperative bacterial contamination may increase the risk of PJIs and the risk of revision in primary hip, knee and shoulder arthroplasty. However, over more than 9 out of 10 patients with an intraoperative contaminated joint arthroplasty did not develop a PJI.

查看原文本刊更多论文

可检测的细菌污染原发性关节置换术和假体周围关节感染的发生率：系统回顾和荟萃分析。

目的：原发性关节置换术中阳性培养与假体周围关节感染（PJIs）之间的关系仍然存在争议。本系统综述和荟萃分析探讨了术中污染与并发症（如PJIs和翻修率）之间的关系。方法：检索PubMed、Web of Science、Cochrane、Emcare （OVID）、Embase （OVID）、MEDLINE、Academic Search Premier以及纳入的评价污染和非污染原发性关节置换术疗效的研究文献。本系统综述和荟萃分析根据PRISMA声明进行，研究方案先验上传到Open Science Framework。两位研究人员独立审查了所有的标题、摘要和全文，并提取了可用的数据。研究资格标准是首次关节置换术，在初始过程中进行培养，记录PJIs和翻修率。结果：根据纳入和排除标准，检索得到26项研究，涉及4556例原发性关节置换术。细菌污染的总发生率为24.7% （95% CI: 19-30%）。污染组PJIs的发生率为2.0% (95% CI: 1.1-2.8%)，而未污染组为1.0% (95% CI: 0.6-1.4%)，合并调整风险比（RR）为2.0 （95% CI: 1.3-3.1）。合并分析显示，因任何原因进行翻修的受污染关节置换术的风险增加，合并RR为1.86 （95% CI: 1.14-3.03）。结论：本系统综述和荟萃分析表明，术中细菌污染可能增加原发性髋关节、膝关节和肩关节置换术中PJIs的风险和翻修的风险。然而，超过9 / 10的手术中污染的关节置换术患者没有发生PJI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Efort Open Reviews Medicine-Orthopedics and Sports Medicine

CiteScore

6.60

自引率

2.90%

发文量

101

审稿时长

13 weeks

期刊介绍： EFORT Open Reviews publishes high-quality instructional review articles across the whole field of orthopaedics and traumatology. Commissioned, peer-reviewed articles from international experts summarize current knowledge and practice in orthopaedics, with the aim of providing systematic coverage of the field. All articles undergo rigorous scientific editing to ensure the highest standards of accuracy and clarity. This continuously published online journal is fully open access and will provide integrated CME. It is an authoritative resource for educating trainees and supports practising orthopaedic surgeons in keeping informed about the latest clinical and scientific advances. One print issue containing a selection of papers from the journal will be published each year to coincide with the EFORT Annual Congress. EFORT Open Reviews is the official journal of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) and is published in partnership with The British Editorial Society of Bone & Joint Surgery.