Preoperative, intraoperative, and postoperative concepts to prevent infection for unicompartmental knee arthroplasty.

Abstract

Periprosthetic joint infection (PJI) is a complication that occurs in less than 1% of patients after unicompartmental knee arthroplasty (UKA). Though infrequent, it may potentially lead to revision while placing a significant financial burden on the healthcare system. Preoperative, intra-operative, and postoperative strategies should be implemented to minimize the risk of PJI. Patient optimization prior to surgery can help to identify patients at risk for PJI and also maximize the health of the patient prior to surgery. Intraoperative and postoperative strategies can also mitigate the risk of postoperative infection. This article will summarize the evidence for preoperative, intra-operative, and postoperative strategies to prevent PJI in UKA. This will include topics on malnutrition and obesity, Staphylococcus aureus, smoking, human immunodeficiency virus, rheumatoid arthritis, as well as skin preparation, laminar air flow, preoperative antibiotic administration antimicrobial incision drapes, pulsatile lavage, vancomycin powder, wound closure method, thromboprophylactic agents, and closed incisional negative pressure wound therapy dressings.