Association between superficial surgical site infection and revision after primary total hip arthroplasty: a cohort study of 3,242 patients
DOI:
https://doi.org/10.2340/17453674.2026.46223Keywords:
Arthroplasty, Hip, InfectionAbstract
Background and purpose: We aimed to evaluate whether a superficial surgical site infection (SSI) after primary total hip arthroplasty (THA) is associated with an increased risk of subsequent revision hip arthroplasty for any cause.
Methods: This is a single-center, observational study based on data from the Norwegian Arthroplasty Register (NAR) and the local infection surveillance program. All patients operated on with a primary THA at our institution from January 1999 through December 2019 were eligible for the study. The risk of revision surgery for any cause was compared between the exposed (superficial SSI) and the unexposed group (no SSI) with frequentist (Cox regression) and Bayesian survival analysis.
Results: 3,242 patients were included in the study. Median follow-up in the NAR was 7, minimum follow-up was 4 years. 27 patients were registered with a superficial SSI. A Cox regression analysis adjusted for sex, age, American Society of Anesthesiologists Physical Status (ASA) class, duration of surgery, and year of surgery gave an adjusted hazard ratio of 1.4 (95% confidence interval: 0.3–5.9, P = 0.6) for the risk of revision for any cause in the exposed group (superficial SSI) compared with the unexposed group (no SSI). A Bayesian survival model, adjusted for the same covariates, gave a censored time coefficient of 0.5 (95% credible interval: 0.1–0.9), with a corresponding very low (1%) probability of an increased risk of revision for any cause in the exposed group.
Conclusion: We showed no association between superficial SSI and revision after primary THA. Thus, our data does not support the dogma that superficial SSIs after primary THA do not exist.
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Copyright (c) 2026 Christian T Pollmann, Owen M T Thomas, Jan Harald M Røtterud, Håvard Dale, Mireille W H Wulf, Inge Skråmm
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