Preoperative nutritional status and post-operative infection in total knee replacements: a prospective study of 213 patients

Abstract

Purpose: To assess the potential relationship between preoperative nutritional status, including anthropometric parameters, and infection following total knee replacement surgery.

Methods: A total of 213 patients undergoing total knee replacement between December 2007 and May 2008 were prospectively studied. Patients with rheumatoid arthritis were excluded. For each patient we pre-operatively checked biochemical and anthropometric parameters of nutrition information about co-morbidities such as diabetes and high blood pressure, ASA score, age, and gender. Information about early infections, both superficial and deep, was collected. A descriptive statistical analysis and univariate/multivariate logistic regression model for risk factors were performed.

Results: Eleven patients (5.16%) had an infection, 5 deep and 6 superficial. Neither co-morbidities nor preoperatively biochemical parameters were associated with infection. However, in the univariate logistic regression model there was an inversely proportional relationship between triceps skinfold (TSF) and infection. After adjusting for age, ASA score and gender (multivariate logistic regression), TSF remained significantly associated with infection.

Conclusion: There was a statistically significant association between TSF and post-operative infection risk after TKR.

Level of evidence: Level I (Prospective prognostic study).