Wound infection in hip and knee arthroplasty

We have studied prospectively the outcome of wound discharge in patients af ter arthroplasty of the hip and knee, Over a period of 3.5 years 530 primar y arthroplasties were carried out in one hospital. postoperative wound infe ctions developed in 82, At a mean follow-up of two Sears a comparison was m ade between these patients and 82 with healthy wounds, in terms of symptoms and signs of deep infection, There was an incidence of 1.1% of early deep infection, within six weeks in all cases. The rate of 'superficial' infection was 17.3% in the hips, 10.5 % in the knees and 14.3% in total. At a mean follow-up of 26 months, there were no significant differences between the patients with infected wounds a nd a matched group of patients with healthy wounds in terms of the ESR, lev el of C-reactive protein, white cell count and radiological scores, but cli nical scores were significantly worse in the patients with infected knees ( p < 0,05), The Length of stay was also significantly longer In this group ( mean 14.6 days in the healthy wound group, 19 days in the problem group; p < 0,005). There was, however, no convincing evidence that these wound infec tions led to deep infection and early revision in the early to medium follo w-up period, A larger and longer prospective trial would be necessary to sh ed more light on this potential problem.