What are the significant risk factors for surgical site infection/periprosthetic joint infection (SSI/PJI) of an oncologic endoprosthesis following resection of a malignant bone tumor?

Authors: Rodolfo Capanna, Ivan Bohaček, Lorenzo Andreani

RECOMMENDATION: Patient-related risk factors for SSI/PJI of an oncologic endoprosthesis include increased patients’ body mass index, overall presence of comorbidities, coexistence of superficial SSI or skin necrosis and lower preoperative hemoglobin or albumin levels. Disease-related risk factors for SSI/PJI of an oncologic endoprosthesis include lesion localization in proximal tibia, pelvis and lesion extending to pelvis from proximal femur. In addition, procedure related risk factors for SSI/PJI include preoperative hospitalization longer than 48 hours, resection of greater than 37% of the proximal tibia, resection of 3 or 4 heads of the quadriceps muscle in distal femoral lesions compared to 1 or 2 heads, increasing surgical time (longer than 2.5 h), use of cemented oncologic endoprosthesis, need for postoperative admission to the intensive care unit, increased postoperative blood transfusion requirement (2 or more units of allogeneic packed cells), presence of postoperative hematoma and the need for additional surgical procedures after the megaprosthesis implantation.

LEVEL OF EVIDENCE: Moderate

DELEGATE VOTE: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)

131