Introduction: Little information is available regarding the rate of prosthetic joint infections (PJIs) in patients undergoing carpal tunnel release (CTR) without antibiotic prophylaxis. Hand surgeons should be aware of patients’ history of arthroplasty.
Methods: All patients who underwent CTR at our institution between 2012 and 2014 were identified and their charts were reviewed to identify those who had a history of total hip, knee, and/or shoulder arthroplasty. Further chart review consisted of identifying a history of PJI, use of perioperative antibiotics, and surgeon awareness of prior arthroplasty.
Results: Two hundred seventy-five CTR surgeries were performed in patients who had previously undergone total joint arthroplasty (TJA). There were no PJIs in any group of patients (P = 0.01). Hand surgeon awareness of the presence of an arthroplasty history had no discernable effect on the choice to use antibiotics.
Conclusions: There was a 0% rate of PJI in our series of patients with a history of TJA who underwent CTR. Overall hand surgeon awareness of TJA status was poor or poorly documented. Routine prophylactic antibiotics may not be indicated in patients undergoing CTR, even with the presence of a prosthetic joint.
Level of Evidence: IV
From the Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY.
Correspondence to: Dr. Elfar: openelfar@gmail.com
Dr. Elfar or an immediate family member serves as a board member, owner, officer, or committee member of the American Society for Surgery of the Hand. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Zeng, Ms. Paul, and Mr. Kemp.
Dr. Elfar acknowledges support by the National Institutes of Health (National Institute of Arthritis and Musculoskeletal Skin Diseases and the National Institute of Child Health and Human Development; grant No. 1 K08 AR060164-01A), support by the American Foundation for Surgery of the Hand (Surgeon Scientist Award), support from the US Department of Defense, and programmatic support from the University of Rochester.
Received May 07, 2016
Accepted September 28, 2016
