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Multiple Periprosthetic Joint Infections: Evidence for Decreasing Prevalence
John P Haverstock1, Lyndsa E Somerville1, Douglas D Naudie1
1Division of Orthopedic Surgery, London Health Sciences Centre, University Hospital, Western University, London, Ontario, Canada.
Background:
Multiple periprosthetic joint infections (MPJIs) are uncommon. We determine the prevalence of developing a second-site periprosthetic joint infection.
Methods:
Our institutional arthroplasty database was reviewed. Those who developed a second-site infection had a retrospective chart review to determine the pathogen, timing of infection, comorbidities, and results of treatment.
Results:
Thirteen of 206 (6.3%) patients at-risk for MPJI experienced a second periprosthetic joint infection. Mode of the second infection was hematogenous in 6, all of whom were being treated for the index periprosthetic joint infection. Seven secondary infections did not relate to the index infection. Two patients were lost to follow-up, 5 continued on suppressive antibiotics, and 6 successfully cleared infection.
Conclusion:
The prevalence of MPJI has decreased compared with previous reports.
Insights
The prevalence of multiple periprosthetic joint infections (MPJIs) is uncommon, with 6.3% of at-risk patients developing a second infection. Some second infections were hematogenous, while others were unrelated to the initial joint replacement infection.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Epidemiology
Background:
- Multiple periprosthetic joint infections (MPJIs) are infrequent occurrences in orthopedic surgery.
- Understanding the incidence of secondary infections is crucial for patient management and outcomes.
Purpose of the Study:
- To determine the prevalence of developing a second-site periprosthetic joint infection (MPJI).
- To analyze the characteristics and outcomes of patients with secondary MPJIs.
Main Methods:
- Retrospective review of an institutional arthroplasty database.
- Chart review for patients who developed a second periprosthetic joint infection to identify pathogen, timing, comorbidities, and treatment outcomes.
Main Results:
- A total of 6.3% (13 of 206) of at-risk patients developed a second periprosthetic joint infection.
- Six secondary infections were hematogenous, occurring during treatment of the index infection.
- Seven secondary infections were unrelated to the initial infection; outcomes included suppressive antibiotics or successful infection clearance.
Conclusions:
- The incidence of multiple periprosthetic joint infections (MPJIs) has shown a decrease compared to historical data.
- Further research may elucidate specific risk factors and optimal management strategies for secondary MPJIs.
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