Rate of Infection in Arthroplasty in Comparison to Surgical Time

Abstract

Surgical site infections (SSIs) and periprosthetic joint infections (PJIs) are among the major complications seen after an arthroplasty procedure; they lead to morbidity, surgical revisions, and medical cost escalation. The operating time has been shown as one of the risk factors for these infections, and hence can be modified by proper intervention. Objective: To determine the rate of surgical site infection in arthroplasty and evaluate its association with operative duration among patients undergoing primary total knee arthroplasty. Methods: From January to June of 2025, this prospective observational cohort study was carried out at the Department of Orthopaedics & Spine Centre, GTTH, Lahore. Included were 94 patients having elective primary total knee arthroplasty. Clinical, perioperative, and demographic information was documented. Using CDC criteria, patients were monitored for ninety days to determine whether surgical site infections had occurred. SPSS version 27.0 was used for statistical analysis. Results: In total, surgical site infections occurred in 8 out of 94 patients (9%). 12% of patients who had surgery for more than 120 minutes had SSI (p=0.07), whereas those who had surgery for less than 120 minutes had no infections. Logistic regression analysis revealed a not statistically significant correlation between an elevated risk of SSI and an operative duration of ≥120 minutes (OR=3.80, p=0.03). Conclusions: After a primary total knee replacement, a longer operating time is linked to a higher risk of surgical site infection. There was a greater chance of postoperative infection in patients whose operations took longer than 120 minutes.