Early-Outcome Differences between Acute and Chronic Periprosthetic Joint Infections-A Retrospective Single-Center...

Area of Science:

• Orthopedics
• Infectious Diseases
• Clinical Outcomes Research

Background:

• Periprosthetic joint infections (PJI) are significant complications following arthroplasty, leading to severe morbidity and mortality.
• Understanding the distinct outcomes of different PJI classifications is crucial for effective patient management.

Purpose of the Study:

• To evaluate and compare the early clinical outcomes of various periprosthetic joint infection entities.
• To identify specific patient characteristics and risk factors associated with different PJI types.

Main Methods:

• A retrospective, single-center study analyzing 115 patients treated for PJI between 2018 and 2019.
• Patients were categorized into early infection (EI), acute late infection (ALI), and chronic infection (CI) groups.
• Outcomes were assessed at 12 months post-treatment, focusing on mortality, relapse-free survival (RFS), and postoperative complications.

Main Results:

• Acute late infections (ALI) group exhibited older patients, higher ASA scores, elevated preoperative CRP, and increased incidence of kidney failure and sepsis.
• ALI patients showed a trend towards higher in-house mortality (21.1%) and ICU admissions (50.0%) compared to EI and CI.
• At 12 months, relapse rates were 15.4% for EI, 38.1% for ALI, and 36.4% for CI, indicating significantly higher relapse rates in ALI and CI.

Conclusions:

• Distinct differences exist in patient characteristics and early outcomes among PJI entities.
• Early infections (EI) demonstrate better early clinical outcomes.
• Acute late infections (ALI) necessitate heightened vigilance during follow-up due to elevated risks of relapse and postoperative complications compared to EI and CI.