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Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
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Extended Oral Antibiotic Prophylaxis After Aseptic Revision Total Hip Arthroplasty: Does It Decrease Infection Risk?

Brandon R Bukowski1, Aaron R Owen1, Travis W Turner1

  • 1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

The Journal of Arthroplasty
|July 8, 2022
PubMed
Summary
This summary is machine-generated.

Extended oral antibiotic prophylaxis (EOA) did not significantly reduce infection risk after aseptic revision total hip arthroplasty (THA). Further research is needed to determine optimal infection prevention strategies for these complex cases.

Keywords:
aseptic revisionextended oral antibiotic prophylaxisinfectionperiprosthetic joint infection (PJI)revision total hip arthroplasty (THA)

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Area of Science:

  • Orthopedic Surgery
  • Infectious Disease
  • Clinical Trials

Background:

  • Extended oral antibiotic prophylaxis (EOA) is established for high-risk primary total hip arthroplasties (THAs).
  • Limited data exist on EOA efficacy in aseptic revision THAs.

Purpose of the Study:

  • To evaluate the impact of EOA on infection-related outcomes in aseptic revision THAs.
  • To compare infection rates between patients receiving EOA and those not.

Main Methods:

  • Retrospective analysis of 1,107 aseptic revision THAs (2014-2019).
  • Comparison of patients receiving EOA (>24 hours) versus no EOA using inverse probability of treatment weighting.
  • Outcomes assessed: cumulative probabilities of infection, periprosthetic joint infection (PJI), and re-revision/reoperation for infection.

Main Results:

  • Cumulative infection probability at 5 years was 3.5%; PJI probability was 2.8%.
  • A trend towards increased infection risk was observed in patients without EOA (HR=2.6 for any infection, HR=2.6 for PJI).
  • Trends for increased re-revision (HR=6.5) or reoperation (HR=2.3) for infection were also noted without EOA.

Conclusions:

  • EOA was not statistically associated with a decreased risk of any infection, PJI, or re-revision/reoperation for infection.
  • Current evidence does not support routine EOA for aseptic revision THAs based on this study.
  • Further investigation may be warranted to identify specific patient subgroups that could benefit from EOA.