Prior hip or knee prosthetic joint infection in another joint increases risk three-fold of prosthetic joint infection after primary total knee arthroplasty
| Autor: | Arlen D. Hanssen, Daniel J. Berry, J T Weston, D. R. Osmon, Brian P. Chalmers, Matthew P. Abdel |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Reoperation musculoskeletal diseases medicine.medical_specialty Prosthesis-Related Infections Arthroplasty Replacement Hip Total knee arthroplasty 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Arthroplasty Replacement Knee Joint (geology) Aged Retrospective Studies Aged 80 and over Arthritis Infectious 030222 orthopedics business.industry Incidence Matched control Prosthetic joint infection Middle Aged United States Surgery Female business Follow-Up Studies Forecasting Total hip arthroplasty |
| Zdroj: | The Bone & Joint Journal. :91-97 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.101b7.bjj-2018-1189.r1 |
| Popis: | AimsThere is little information regarding the risk of a patient developing prosthetic joint infection (PJI) after primary total knee arthroplasty (TKA) when the patient has previously experienced PJI of a TKA or total hip arthroplasty (THA) in another joint. The goal of this study was to compare the risk of PJI of primary TKA in this patient population against matched controls.Patients and MethodsWe retrospectively reviewed 95 patients (102 primary TKAs) treated between 2000 and 2014 with a history of PJI in another TKA or THA. A total of 50 patients (53%) were female. Mean age was 69 years (45 to 88) with a mean body mass index (BMI) of 36 kg/m2(22 to 59). In total, 27% of patients were on chronic antibiotic suppression. Mean follow-up was six years (2 to 16). We 1:3 matched these (for age, sex, BMI, and surgical year) to 306 primary TKAs performed in 306 patients with a THA or TKA of another joint without a subsequent PJI. Competing risk with death was used for statistical analysis. Multivariate analysis was followed to evaluate risk factors for PJI in the study cohort.ResultsThe cumulative incidence of PJI in the study cohort (6.1%) was significantly higher than the matched cohort (2.6%) at ten years (hazard ratio (HR) 3.3; 95% confidence interval 1.18 to 8.97; p = 0.02). Host grade in the study group was not a significant risk factor for PJI. Patients on chronic suppression had a higher rate of PJI (HR 15; p = 0.002), with six of the seven patients developing PJI in the study group being on chronic suppression. The new infecting microorganism was the same as the previous in only two of seven patients.ConclusionIn this matched cohort study, patients undergoing a clean primary TKA with a history of TKA or THA PJI in another joint had a three-fold higher risk of PJI compared with matched controls with ten-year cumulative incidence of 6.1%. The risk of PJI was 15-fold higher in patients on chronic antibiotic suppression; further investigation into reasons for this and mitigation strategies are recommended. Cite this article: Bone Joint J 2019;101-B(7 Supple C):91–97 |
| Databáze: | OpenAIRE |
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