Risk Factors for Infection After Knee Replacement Surgery

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Though uncommon, joint infections can develop after joint replacement surgery. Several factors are associated with an increased risk of serious infections after knee replacement. Building on what doctors already know about risk factors for joint infection, a study published in The Lancet in 2019 breaks out the risks associated specifically with knee replacement.

Researchers analyzed the results of 679,010 knee replacements performed between 2003 and 2013 in England and Wales. They reviewed the patients’ medical records from the time of their initial surgery until an average of 4½ years later. By doing so, they were able to identify key factors associated with deep joint infection and needed additional surgery, including:

  • A history of diabetes, chronic obstructive pulmonary disease, liver disease, a connective tissue or rheumatic disease, or peripheral vascular disease
  • Age younger than 62
  • Male gender
  • A high body mass index (BMI)
  • An injury or an inflammatory joint disease such as rheumatoid arthritis as the reason for replacement
  • A prior infection in the knee being replaced
  • General, instead of local, anesthesia used during surgery.

In previous studies, smoking and alcohol consumption have been established as factors associated with infection.

If you’re planning a joint replacement, work with your doctor to modify some of your risk factors before your surgery.