Preoperative infection risk assessment in hip arthroplasty a matched-pair study of the reliability of 3 validated risk scales


Peri-prosthetic infection, total hip arthroplasty, infection, risk assessment, scales

Published online: Jan 08 2024


1 Orthopaedic and Trauma Department, “Luigi Sacco” Hospital, ASST FBF-Sacco, Milano, Italy
2 School of Medicine and Residency Program in Orthopaedics, University of Pavia, Pavia, Italy
3 Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
4 Knee and Hip reconstrutive surgery and Sports Medicine Department, Istituto Clinico Sant Ambrogio - IRCCS Galeazzi, Milano, Italy


Peri-prosthetic infection (PJI) represents one of the most devastating complications of total hip arthroplasty (THA). The aim of this study is to assess the reliability of different PJI risk assessment scales between two matched pairs of THA groups. This study included 37 patients with PJI following THA performed between 2012 and 2020 (Group A). Each patient in this group was matched, based on sex, age, and follow-up duration, with a control patient who underwent the same surgical procedure without any septic complications (Group B) during the same period. Each patient’s assessment included the American Society of Anesthesiologists (ASA) score and a retrospective evaluation using three different preoperative, specific PJI risk assessment scales: the International Consensus Meeting (ICM) Preoperative Risk Calculator for PJI, the Mayo PJI Risk Score, and the KLIC-score. The two groups were statistically compared using descriptive analyses, both for binomial data and numerical variables. Statistically significant higher values were observed in the preoperative ASA score and surgical time in Group A. Statistically different higher scores were determined only with the ICM risk calculator score in Group A. No significant differences were found using the KLIC score and Mayo score between the two groups. We emphasize the reliability of the ASA score as a nonspecific preoperative assessment scale for PJI. The ICM risk calculator was confirmed as a reliable, specific preoperative assessment scale for PJI, suggesting its routine adoption in THA clinical practice.