Knowledge and attitudes of orthopedic surgeons regarding prosthesis joint infection

Table 1 Number of years as an orthopedic and traumatology specialist

	Frequency	%
< 5	37	14.0
5-10 yr	54	20.5
10-20 yr	104	39.4
> 20 yr	69	26.1
Total	264	100.0

Table 2 Average number of arthroplasty operations per year

	Frequency	%
< 50	102	38.6
50-100	85	32.2
100-200	50	18.9
> 200	27	10.2
Total	264	100.0

Table 3 Hospital type

	Frequency	%
State hospital	65	24.6
University hospital	53	20.1
Training and research hospital	47	17.8
Private hospital	99	37.5
Total	264	100.0

Table 4 Participants' answers to the questions that examine attitudes towards periprosthetic joint infection

	Never		Rarely		Occasionally		Frequently		Always
	Frequency	%	Frequency	%	Frequency	%	Frequency	%	Frequency	%
Do you consult your patients to the dentist before total knee or hip arthroplasty?	94	35.6	61	23.1	61	23.1	21	8	27	10.2
Do you perform urine screening prior to elective arthroplasty of a patient with no symptoms of urinary tract infection?	119	45.1	25	9.5	22	8.3	21	8	77	29.2
Do you delay elective arthroplasty of asymptomatic patients with bacteriuria?	186	70.5	14	5.3	29	11	14	5.3	21	8
Do you screen your patients for nasal MRSA carriage prior to elective arthroplasty?	179	67	28	10.6	20	7.6	9	3.4	28	10.6
Do you recommend chlorhexidine bathing to your patients before elective arthroplasty?	117	44.3	15	5.7	35	13.3	19	7.2	78	29.5
Do you administer surgical prophylaxis in the second stage of the two-stage revision surgery?	10	3.8	0	0	13	4.9	10	3.8	231	87.5
Do you pay attention to the fact that the prophylaxis agent covers the patient's previously isolated prosthetic infection agent?	11	4.2	2	0.8	9	3.4	16	6.1	226	85.6
Do you administer surgical prophylaxis for a mega prosthesis (TM prosthesis) longer than 24 h?	40	15.2	8	3	27	10.2	26	9.8	163	61.7
Do you have your patients wear a mask during arthroplasty surgery?	214	81.1	15	5.7	14	5.3	5	1.9	16	6.1

MRSA: Methicillin-resistant Staphylococcus aureus.

Table 5 Prophylaxis agent and dosage used in arthroplasty operations

	Frequency	%
1 g of cefazolin	75	28.4
2 g of cefazolin	128	48.5
I adjust cefazolin according to the patient's weight.	55	20.8
Gentamicin	1	0.4
Other	5	1.9
Total	264	100.0

Table 6 Participants' answers to the questions that examine their knowledge

Participants' answers	Never		Rarely		Occasionally		Frequently		Always
	Frequency	%	Frequency	%	Frequency	%	Frequency	%	Frequency	%
The patient should consult the dentist before total knee or hip arthroplasty	20	7.6	37	14	63	23.9	15	5.7	57	21.6
A urinary test should be ordered for the patient with dysuria complaint during the preoperative stage of an arthroplasty operation	33	12.5	22	8.3	29	11	13	4.9	95	36
Surgical prophylaxis should be administered in the second stage of a two-stage revision surgery	16	6.1	2	0.8	5	1.9	11	4.2	158	59.8
Prophylaxis agents should involve the factor of previously isolated prosthesis infection	9	3.4	2	0.8	4	1.5	6	2.3	171	64.8
Gloves should be definitely changed after contact with cement	14	5.3	10	3.8	26	9.8	25	9.5	117	44.3
For the diagnosis of prosthesis infection, 3–5 culture samples should be obtained	11	4.2	5	1.9	19	7.2	20	7.6	137	51.9
Irrigation and debridement should be applied to the patient in case of persistent drainage that continues more than 1 week after the total hip and knee arthroplasty operation	19	7.2	21	8.0	51	19.3	16	6.1	85	32.2
Surgical prophylaxis should not be longer than 24 hours for a mega prosthesis	52	19.7	18	6.8	43	16.3	11	4.2	68	25.8
The risk of infection increases as the duration of surgery gets longer	4	1.5	3	1.1	4	1.5	3	1.1	178	67.4

Table 7 Comparison of participants' knowledge level and work experience

	n	Mean	Standard deviation	Standard error
< 5	21	3.7143	0.71277	0.15554
5-10 yr	42	3.8829	0.52707	0.08133
10-20 yr	74	3.9032	0.54305	0.06313
> 20 yr	55	3.7924	0.60175	0.08114
Total	192	3.8464	0.57638	0.04160

Table 8 Comparison of participants' knowledge level and type of hospital they work in

Hospital type (I)	Hospital type (J)	Mean difference (I-J)	Standard error	Significance
State hospital	University hospital	-0.21482	0.12318	0.304
	Training and research hospital	-0.382341	0.13071	0.020
	Private hospital	-0.21535	0.10486	0.172
University hospital	State hospital	0.21482	0.12318	0.304
	Training and research hospital	-0.16752	0.13730	0.615
	Private hospital	-0.00053	0.11296	1.000
Training and research hospital	State hospital	0.382341	0.13071	0.020
	University hospital	0.16752	0.13730	0.615
	Private hospital	0.16699	0.12113	0.514
Private hospital	State hospital	0.21535	0.10486	0.172
	University hospital	0.00053	0.11296	1.000
	Training and research hospital	-0.16699	0.12113	0.514

¹The mean difference is significant at the 0.05 level.