Department of Orthopaedics & Traumatology, Ankara Guven Hospital, Ankara, 06370, Turkey.
Department of Orthopaedics, Helios ENDO-Klinik, Hamburg, Germany.
Arch Orthop Trauma Surg. 2024 Dec;144(12):5267-5272. doi: 10.1007/s00402-024-05548-3. Epub 2024 Oct 14.
The prevalence of obesity is increasing worldwide and it is known to be associated with many postoperative complications, including infection. Patients' body fat distribution may vary and body mass index (BMI) does not provide sufficient information about adipose tissue thickness of the lower extremities. The aim of this study is to investigate the relationship between thigh diameters and early postoperative prosthesis-related joint infections (PJI) in patients who underwent arthroplasty.
The study included 76 patients and 114 knees who were operated on by a single surgeon and underwent total knee arthroplasty (TKA) due to primary knee osteoarthritis between May 2022 and September 2023 in a tertiary reference hospital. Circumference of the thickest part of the operated thigh (cm), preoperative erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, height, weight, BMI and the presence of early postoperative prosthesis-related joint infections were evaluated.
The mean BMI was 32.6 ± 4.2 (kg/m). Two (2.6%) were normal weight, 14 (18.5%) were overweight, 58 (76.3%) were obese and 2 (2.6%) were morbidly obese. The mean circumference of the thickest part of the thigh was 57.56 ± 6.38 (cm). 6 patients were diagnosed with PJI in the acute phase. The mean circumference of the thickest part of the thigh was statistically significantly greater in the group with acute PJI compared to the group without PJI (p = 0.048).
The incidence of acute PJI was found to be significantly higher in patients with larger thigh diameters, whereas no such relationship was observed for BMI. The incorporation of preoperative soft tissue envelope measurements into routine clinical examination may prove beneficial in reducing the risk of PJI.
肥胖症在全球范围内的患病率不断增加，已知与许多术后并发症有关，包括感染。患者的体脂分布可能有所不同，而体重指数（BMI）并不能提供有关下肢脂肪组织厚度的充分信息。本研究旨在探讨接受关节置换术的患者大腿直径与术后早期与假体相关的关节感染（PJI）之间的关系。
该研究纳入了 2022 年 5 月至 2023 年 9 月期间在一家三级参考医院由同一位外科医生进行的 76 例患者和 114 例膝关节的手术，这些患者因原发性膝关节骨关节炎接受了全膝关节置换术（TKA）。评估了手术大腿最粗部位的周长（cm）、术前红细胞沉降率（ESR）和 C 反应蛋白（CRP）水平、身高、体重、BMI 以及术后早期与假体相关的关节感染的存在情况。
平均 BMI 为 32.6±4.2（kg/m）。其中 2 例（2.6%）为正常体重，14 例（18.5%）为超重，58 例（76.3%）为肥胖，2 例（2.6%）为病态肥胖。大腿最粗部位的平均周长为 57.56±6.38（cm）。有 6 例患者在急性期被诊断为 PJI。急性 PJI 组的大腿最粗部位周长明显大于无 PJI 组（p=0.048）。
与 BMI 相比，大腿直径较大的患者急性 PJI 的发生率明显更高。术前软组织包绕测量值纳入常规临床检查可能有助于降低 PJI 的风险。
