Risk factors for recurrence of periprosthetic joint infection following operative management: a cohort study with average 5-year follow-up.

Autor:	Ekhtiari S; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada., Gazendam A; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada., Saidahmed A; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada., Petruccelli D; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada., Winemaker MJ; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada., de Beer JD; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada., Shah V; Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA., Wood TJ; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Jazyk:	angličtina
Zdroj:	Annals of joint [Ann Jt] 2022 Sep 26; Vol. 8, pp. 2. Date of Electronic Publication: 2022 Sep 26 (Print Publication: 2023).
DOI:	10.21037/aoj-22-4
Abstrakt:	Background: Periprosthetic joint infections (PJIs) remain challenging to eradicate even after surgical management, which in most cases involves either debridement, antibiotics and implant retention (DAIR) or single- or two-staged revision. The purpose of this study is to determine predictors of PJI recurrence after operative management for PJI, and to determine differences in recurrence-free survival between DAIR and staged revision. Methods: This is a retrospective analysis of prospectively collected data of revision hip and knee arthroplasty surgeries due to PJI between 2011 and 2018 at an academic hospital. Any patient undergoing revision surgery for PJI was included except if the index surgery information was unknown. The primary outcome was confirmed PJI recurrence. Multivariable logistic regression analysis was utilized to determine the relationship between the predictor variables and outcome variable. Log rank testing was used to compare recurrence-free survival between DAIR and staged revision. Results: A total of 89 patients (91 joints) underwent revision surgery due to PJI. Younger age and presence of a sinus tract were statistically significant for risk of PJI recurrence. A multivariable logistic regression model including both variables was significant for predicting recurrence of PJI (χ 2 =10.2, P=0.006). Survival was not significantly different between patients who underwent DAIR versus a staged revision. Conclusions: Younger patients and those with a chronic sinus tract are at significantly higher risk of recurrent PJI. This study also demonstrated that PJI can be successfully managed in the majority of cases with DAIR or staged revision. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://aoj.amegroups.com/article/view/10.21037/aoj-22-4/coif). The authors have no conflicts of interest to declare. (2023 Annals of Joint. All rights reserved.)
Databáze:	MEDLINE
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