• Jie Chen, Yunying Cui, Xin Li, Xiangwan Miao, Zhanpeng Wen, Yan Xue, and Jing Tian.
• Second Clinical Medical College of Southern Medical University, No.253 Gongye Avenue, Haizhu, Guangzhou, Guangdong, China.
• Arch Orthop Trauma Surg. 2013 May 1;133(5):675-87.

ObjectiveEstimated the risk factors for postoperative infection after total knee arthroplasty (TKA) to prevent its occurrence.DesignThe meta-analysis collected twelve cohorts or case-control studies which included 548 infected persons in 57,223 general cases. Review Manager 5.0 was operated to assess the heterogeneity and to give an overall estimate of the association of factors with postoperative infection after TKA.ResultsThe main factors distinctly associated with infection after TKA were BMI (BMI >30: OR = 2.53, 95 % CI 1.25, 5.13; BMI >40: OR = 4.00, 95 % CI 1.23, 12.98), diabetes mellitus (OR = 3.72, 95 % CI 2.30, 6.01), hypertension (OR = 2.53, 95 % CI 1.07, 5.99), steroid therapy (OR = 2.04, 95 % CI 1.11, 3.74), and rheumatoid arthritis (OR = 1.83; 95 % CI 1.42, 2.36). It had no sufficient evidences to reveal that gender could lead to infection after TKA. Osteoarthritis appeared to have a moderately protective effect. Statistical analysis revealed no correlation between urinary tract infection, fixation method, ASA, bilateral operation, age, transfusion, antibiotics, bone graft, and infection.ConclusionThere were positive evidences for some certain factors which could be targeted for prevention of the onset of infection, but more studies are needed to define the association of some other controversial factors in infection, like osteoarthritis, gender and so on. The quality of studies also needs to be improved.

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