Joint-Specific Effects of Previous Arthroscopic Surgery on the Risk of Infection Following Knee, Hip, and Shoulder Arthroplasty: A Meta-Analysis Based on Observational Studies.

Abstract

Objective: To explore the effects of a prior history of arthroscopic surgery on the risk of postoperative infection following knee, hip and shoulder arthroplasty.

Methods: Searched relevant literature from four major English databases up to August 10, 2025. A total of 31 observational studies were included. The generalized linear mixed model was used to pool effect sizes and calculate the odds ratios (OR) for postoperative infection after joint arthroplasty. Subgroup analyses stratified by joint type were performed, and the pooled incidence rates of infection were synthesized.

Results: A prior arthroscopic surgery significantly increased the risks of overall infection (OR = 1.33, 95%CI: 1.14-1.56) and deep infection (OR = 1.38, 95%CI: 1.17-1.63) after joint arthroplasty, with obvious heterogeneity among different joints. A history of knee arthroscopy was associated with elevated postoperative infection risks, and prior shoulder arthroscopy markedly increased the risk of deep infection. No significant correlation was observed between hip arthroscopy and infection risk. The pooled overall and deep postoperative infection rates were both 2% in this population.

Conclusion: Clinicians should attach importance to this joint-specific risk when formulating treatment plans. Further studies focusing on the shoulder joint are required to validate the present findings.