Impact of surgical site infection on patients’ outcome after fixation of tibial plateau fractures: a retrospective multicenter study
Open Access
- 9 June 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Musculoskeletal Disorders
- Vol. 22 (1), 1-9
- https://doi.org/10.1186/s12891-021-04402-6
Abstract
Background: Surgical site infection (SSI) occurs in 3–10 % of patients with surgically treated tibial plateau fractures. This study aimed to evaluate the impact of SSI on patients’ outcome after fixation of tibial plateau fractures. Methods: We conducted a retrospective multicenter study in seven participating level I trauma centers between January 2005 and December 2014. All participating centers followed up with patients with SSI. In addition, three centers followed up with patients without SSI as a reference group. Descriptive data and follow-up data with patient-reported outcome scores (Knee Injury and Osteoarthritis Outcome Score [KOOS] and Lysholm knee scoring scale score) were evaluated. Results: In summary, 287 patients (41 with SSI and 246 without SSI; average 50.7 years) with an average follow-up of 75.9 ± 35.9 months were included in this study. Patients with SSI had a significantly poorer overall KOOS (KOOS5) (48.7 ± 23.2 versus [vs.] 71.5 ± 23.5; p < 0.001) and Lysholm knee scoring scale score (51.4 ± 24.0 vs. 71.4 ± 23.5; p < 0.001) than patients without SSI. This significant difference was also evident in the KOOS subscores for pain, symptoms, activities of daily living (ADL), and quality of life (QoL). SSI remained an important factor in multivariable models after adjusting for potential confounders. Clinically relevant differences in the KOOS5 and KOOS subscores for symptoms, pain, and ADL were found between those with SSI and without SSI even after adjustment. Furthermore, the number of previous diseases, Arbeitsgemeinschaft für Osteosynthesefragen Foundation (AO) C fractures, and compartment syndrome were found to be additional factors related to poor outcome. Conclusions: Compared to previous studies, validated patient-reported outcome scores demonstrated that the impact of SSI in patients with surgically treated tibial plateau fractures is dramatic, in terms of not only pain and symptoms but also in ADL and QoL, compared to that in patients without SSI.Funding Information
- Universitätsklinikum Leipzig
This publication has 29 references indexed in Scilit:
- Surgical fixation methods for tibial plateau fracturesEmergencias, 2015
- Mid- to long-term functional outcome after open reduction and internal fixation of tibial plateau fracturesInjury, 2015
- Functional outcome after tibial plateau fracture osteosynthesis: A mean follow-up of 6yearsThe Knee, 2014
- The outcome following fixation of bicondylar tibial plateau fracturesThe Bone & Joint Journal, 2014
- Medium-term results after complex intra-articular fractures of the tibial plateauJournal of Orthopaedic Science, 2013
- Lysholm Score and Tegner Activity Level in Individuals with Normal KneesThe American Journal of Sports Medicine, 2009
- Operative Treatment of 109 Tibial Plateau Fractures: Five- to 27-Year Follow-up ResultsJournal of Orthopaedic Trauma, 2007
- Der Knee Injury and Osteoarthritis Outcome Score - ein Funktionsfragebogen zur Outcome-Messung in der KnieendoprothetikZeitschrift Fur Orthopadie Und Ihre Grenzgebiete, 2003
- Knee Injury and Osteoarthritis Outcome Score (KOOS)—Development of a Self-Administered Outcome MeasureJournal of Orthopaedic & Sports Physical Therapy, 1998
- THE INJURY SEVERITY SCOREThe Journal of Trauma and Acute Care Surgery, 1974