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A Periprosthetic Joint Candida albicans Infection Model in Mouse

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Published on: February 2, 2024

Periprosthetic joint infection can cause abnormal systemic coagulation.

Arjun Saxena¹, Michael Baratz, Matthew S Austin

¹Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

The Journal of Arthroplasty

|December 18, 2010

Summary

Over half of patients with periprosthetic joint infection (PJI) experience abnormal blood coagulation. Treatments to reverse this coagulopathy in PJI patients show limited efficacy, suggesting underlying biological factors.

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Area of Science:

Orthopedic Surgery
Infectious Diseases
Hematology

Background:

Periprosthetic joint infection (PJI) often necessitates surgical intervention.
Coagulation abnormalities are a potential complication in PJI patients.
Understanding coagulation status is crucial for managing PJI patients.

Purpose of the Study:

To determine the incidence of abnormal coagulation in patients with PJI.
To evaluate the effectiveness of treatments aimed at correcting coagulopathy in this cohort.

Main Methods:

Retrospective analysis of 294 patients treated for PJI between 1998 and 2005.
Assessment of coagulation status using the international normalized ratio (INR).
Evaluation of treatment efficacy for abnormal INR in a subset of patients.

Main Results:

56% of patients (72 out of 294) presented with abnormal coagulation (INR >1.12).
Only 24.1% (7 out of 29) of patients treated with fresh frozen plasma and/or vitamin K achieved normalized INR.
Abnormal coagulation was observed even in patients not on anticoagulation therapy.

Conclusions:

A high incidence of abnormal coagulation exists in patients with PJI.
Standard treatments for coagulopathy are often ineffective in normalizing INR for PJI patients.
PJI may involve circulating factors that actively disrupt normal blood coagulation.