DOI: 10.1177/17571774261493863 ISSN: 1757-1774

Local infiltration anesthesia does not increase infection risk after total hip arthroplasty: A single-center retrospective cohort study

Artsiom Abialevich, Vadim Benkovich
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Background

Local infiltration anesthesia (LIA) is commonly used in primary total hip arthroplasty (THA) for multimodal pain control. This study evaluated whether periarticular LIA affects early wound complications or postoperative infection after cementless THA.

Methods

This retrospective cohort study included 1319 primary cementless THAs performed between 2018 and 2025, comparing LIA ( n = 852) and no-LIA ( n = 467) groups, performed in outpatient surgery center. Baseline, perioperative, and early postoperative outcomes were analyzed, and multivariable logistic regression evaluated the association between LIA use and wound complications after adjustment for confounders.

Results

Baseline characteristics were largely comparable, although BMI and Charlson Comorbidity Index were slightly higher in the no-LIA group (both p < .001). Overall wound complication rates were low and similar between groups (4.46% vs 4.71%, p = .834), with no significant differences in prolonged drainage, hematoma, superficial infection, or 90-day readmission. No deep infection or periprosthetic joint infection occurred in either group. LIA was not independently associated with wound complications on multivariable analysis (adjusted OR 0.85, 95% CI 0.48–1.48, p = .559), with consistent findings across obesity, diabetes, and smoking subgroups.

Conclusions

Periarticular local infiltration anesthesia in primary cementless THA was not associated with higher early wound complication or infection risk.

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