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Mortality During Total Knee Periprosthetic Joint Infection
Zachary C Lum1, Kyle M Natsuhara1, Trevor J Shelton1
1Department of Orthopedics, University of California, Davis Medical Center, Sacramento, CA.
The Journal of Arthroplasty
|September 19, 2018
Summary
Mortality after 2-stage revision for periprosthetic joint infection (PJI) of the knee is high, with a 5-year rate of 21.64%. Patients face a significantly increased risk of death compared to the general population.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Public Health
Background:
- Periprosthetic joint infections (PJIs) are serious complications following knee replacement surgery.
- PJIs lead to poor outcomes, including disability, reinfection, and increased mortality.
- Effective management strategies for PJI are crucial.
Purpose of the Study:
- To systematically review the mortality rate of periprosthetic joint infection (PJI) of the knee undergoing 2-stage revision.
- To determine if the mortality rate has improved over time.
- To compare PJI mortality to that of the general population.
Main Methods:
- A systematic review of studies was conducted using databases like MEDLINE/EMBASE and PubMed.
- Keywords included 'periprosthetic joint infection,' 'mortality rates,' 'total knee arthroplasty,' and 'outcomes after two stage revision.'
- 14 studies involving 20,719 patients were included in the analysis.
Main Results:
- The average mortality percentage after 2-stage revision for total knee PJI was 14.4%, with a 5-year mortality rate of 21.64%.
- One-year mortality was 4.33%, with a significant increase in mortality thereafter.
- The risk of death after total knee PJI was 3.05 times higher than in the age-adjusted general population.
Conclusions:
- The mortality rate associated with 2-stage total knee revision for periprosthetic joint infection is notably high.
- Healthcare providers must discuss the risk of death with patients undergoing this procedure.
- Further research may be needed to improve outcomes and reduce mortality in PJI cases.
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