Abstract
This retrospective
study explored the association between osteoarthrosis and infectious
complications and evaluated infection-preventive nursing interventions in 60
patients with osteoarthrosis. Patients were divided into infected group (n=22,
with documented joint or systemic infection) and non-infected group (n=38,
without infection), with each group split into intervention (infected: n=12;
non-infected: n=20) and control (infected: n=10; non-infected: n=18) subgroups.
Intervention subgroups received infection-preventive nursing (aseptic technique
training, skin integrity management, immunization promotion), while controls
received routine care. Primary outcomes included correlation between
osteoarthrosis severity (Kellgren-Lawrence grade) and infection risk and
post-intervention infection recurrence rate at 6 months. Secondary outcomes
included C-reactive protein (CRP) levels, antibiotic use duration and wound
healing time. Results showed significant positive correlation between
Kellgren-Lawrence grade and infection risk (r=0.65, p<0.01). Intervention
subgroups had lower recurrence rate (infected: 16.7% vs 60.0%; non-infected:
5.0% vs 27.8%, p<0.05). Infection-preventive nursing reduces infectious
complications in osteoarthrosis patients, particularly those with severe
disease and comorbidities.
Keywords: Osteoarthrosis; Skin integrity management; Kellgren-lawrence
grade; C-reactive protein
Introduction
Infectious
complications, including septic arthritis and soft tissue infections, are
serious but underrecognized issues in osteoarthrosis patients, with incidence
increasing from 2.3% in mild disease to 8.7% in severe cases1. Advanced osteoarthrosis-related joint deformity,
skin breakdown and immunosuppressive medication use create vulnerability to
infection, which can accelerate joint destruction and increase mortality2. This study investigates the osteoarthrosis-infection
association and evaluates targeted nursing interventions, addressing the lack
of infection-specific prevention protocols3.
Methods
Study design and
participants
Retrospective analysis of 60 patients with
radiographically confirmed osteoarthrosis (knee: 40 cases, hip: 20 cases).
Inclusion criteria: age 50-85 years; Kellgren-Lawrence grade I-IV; follow-up ≥6
months. Infected group defined as positive culture from joint aspirate or wound
or clinical signs (erythema, warmth, purulence) with CRP >50 mg/L. Exclusion
criteria: rheumatoid arthritis, recent joint surgery and congenital
immunodeficiency.
Grouping & interventions
Control subgroups: Routine care (pain
management, mobility advice).
Intervention subgroups:
Added infection-preventive interventions:
• Aseptic technique training: Teaching patients/caregivers wound cleaning, dressing change and joint aspiration site care.
• Skin integrity management: Moisturizing protocols for dry skin, pressure ulcer prevention and early detection of skin cracks.
• Immunization promotion: Administering pneumococcal and influenza vaccines, monitoring vaccination status.
• Antibiotic stewardship: Educating on proper antibiotic use, preventing self-medication and resistance.
Outcome measures
• Primary: Correlation between Kellgren-Lawrence grade and infection risk; 6-month infection recurrence rate.
• Secondary: CRP levels (mg/L), antibiotic use duration (days) and wound healing time (days).
Statistical analysis
SPSS 26.0 used for
Pearson correlation, χ² tests and independent t-tests. p<0.05 was
significant.
Results
Osteoarthrosis-erythema-swelling association and
baseline data
Significant positive
correlation between Kellgren-Lawrence grade and infection risk (r=0.65,
p<0.01). Infected group had higher initial Kellgren-Lawrence grade and
comorbidity burden (Table 1).
Table 1: Baseline
Characteristics
|
Characteristics |
Infected Group (n=22) |
Non-Infected Group (n=38) |
p-value |
|
Age (years, x̄±s) |
68.5±9.2 |
64.2±8.7 |
0.08 |
|
Male gender, n(%) |
13(59.1) |
20(52.6) |
0.63 |
|
Affected joint (knee/hip) |
15(68.2)/7(31.8) |
25(65.8)/13(34.2) |
0.85 |
|
Kellgren-Lawrence grade (x̄±s) |
3.2±0.7 |
2.1±0.8 |
<0.001 |
|
Diabetes mellitus, n(%) |
9(40.9) |
8(21.1) |
0.08 |
|
Initial CRP (mg/L, x̄±s) |
87.3±32.5 |
12.6±8.3 |
<0.001 |
|
Immunosuppressant use, n(%) |
7(31.8) |
5(13.2) |
0.07 |
Table 2: 6-Month Infection
Recurrence Rate
|
Group |
Intervention |
Control |
p-value |
|
Infected Group (n=22) |
2/12(16.7%) |
6/10(60.0%) |
0.028 |
|
Non-Infected Group (n=38) |
1/20(5.0%) |
5/18(27.8%) |
0.049 |
Secondary outcomes
Intervention subgroups
demonstrated significant improvements in all secondary measures (Table 3).
Table 3: Secondary Outcomes at 6
Months
|
Outcome |
Infected Group |
Non-Infected Group |
p-value (intervention effect) |
|
CRP (mg/L, x̄±s) |
Intervention:15.2±6.3 |
Intervention:8.7±4.2 |
<0.001 |
|
|
Control:38.5±12.1 |
Control:16.3±7.5 |
- |
|
Antibiotic duration (days, x̄±s) |
Intervention:14.3±4.1 |
Intervention:0 |
0.001 |
|
|
Control:26.8±7.5 |
Control:5.2±3.1 |
- |
|
Wound healing time (days, x̄±s) |
Intervention:18.5±5.3 |
Intervention:0 |
0.002 |
|
|
Control:32.6±8.7 |
Control:12.5±4.8 |
- |
Discussion
This study confirms
severe osteoarthrosis correlates with higher infection risk, consistent with
mechanisms involving joint instability-induced skin trauma and chronic
inflammation-related immune dysfunction4. The 3.2-fold
higher Kellgren-Lawrence grade in the infected group aligns with data that
advanced joint degeneration disrupts protective barriers5.
Infection-preventive
interventions reduced complications through aseptic training, which addressed
60% of preventable infections from improper wound care6. Skin integrity
management prevented entry points for pathogens, while immunization boosted
host defence-particularly valuable in elderly patients with age-related immune
decline7. Notably, the non-infected intervention subgroup
achieved 5% infection rate, highlighting prevention value in high-risk
populations8.
Limitations include
lack of long-term microbiological surveillance and potential confounding by
unrecorded antibiotic use. Future studies should incorporate pathogen-specific
analysis.
Conclusion
Osteoarthrosis severity
correlates significantly with infectious complication risk.
Infection-preventive nursing interventions effectively reduce recurrence,
shorten recovery time and lower antibiotic use. These strategies are critical
for managing infection risk in osteoarthrosis patients, especially those with
severe disease.
References
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