Periprosthetic Joint Infection: The Incidence, Timing, and Predisposing Factors

TLDR

Periprosthetic joint infection is one of the most challenging complications of joint arthroplasty. The study aimed to identify current risk factors, incidence, and timing of periprosthetic joint infection after modern joint arthroplasty. Data from 9,245 primary hip or knee arthroplasty patients between 2001 and 2006 were prospectively reviewed. In this cohort, 63 patients (0.7%) developed infection, 65% within the first year, 91% had an isolated organism (most often *Staphylococcus aureus* or *S. epidermidis*), and independent predictors included higher ASA score, morbid obesity, bilateral arthroplasty, knee arthroplasty, allogenic transfusion, postoperative atrial fibrillation, myocardial infarction, urinary tract infection, and longer hospitalization.

Abstract

Periprosthetic joint infection is one of the most challenging complications of joint arthroplasty. We identified current risk factors of periprosthetic joint infection after modern joint arthroplasty, and determined the incidence and timing of periprosthetic joint infection. We reviewed prospectively collected data from our database on 9245 patients undergoing primary hip or knee arthroplasty between January 2001 and April 2006. Periprosthetic joint infections developed in 63 patients (0.7%). Sixty-five percent of periprosthetic joint infections developed within the first year of the index arthroplasty. The infecting organism was isolated in 57 of 63 cases (91%). The most common organisms identified were Staphylococcus aureus and Staphylococcus epidermidis. We identified the following independent predictors for periprosthetic joint infection: higher American Society of Anesthesiologists score, morbid obesity, bilateral arthroplasty, knee arthroplasty, allogenic transfusion, postoperative atrial fibrillation, myocardial infarction, urinary tract infection, and longer hospitalization. This study confirmed some previously implicated factors and identified new variables that predispose patients to periprosthetic joint infection.Level II, prognostic study.