Risk of Periprosthetic Joint Infection in Patients With Ipsilateral Infected Arthroplasties

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Biomedical Engineering

Background:

• The risk of developing a second periprosthetic joint infection (PJI) after an initial PJI is approximately 18%-20%.
• Limited research exists on the incidence of secondary PJI in ipsilateral joints.
• This study re-evaluates the incidence and risk factors for ipsilateral PJI.

Purpose of the Study:

• To determine the incidence of developing a second PJI in the ipsilateral joint after an initial PJI.
• To identify potential risk factors associated with ipsilateral PJI.
• To compare the risk of ipsilateral PJI with contralateral PJI.

Main Methods:

• Retrospective review of lower-extremity PJI cases from 2015-2021.
• Inclusion of patients with multiple ipsilateral arthroplasties.
• Identification of infection timing, risk factors, bacterial source, and bacteremia.

Main Results:

• Of 392 PJI patients, 179 had multiple prosthetic joints; 47 had ipsilateral prostheses.
• Three patients (6.4%) developed ipsilateral PJI; 10 patients (21.3%) developed a separate PJI overall.
• Immunosuppressant use was associated with a higher likelihood of developing a second ipsilateral PJI (P = .02).

Conclusions:

• The risk of ipsilateral PJI is not greater than contralateral PJI.
• Having an infected TJA in one limb does not significantly increase the risk of infection in the contralateral limb.
• Immunosuppressant use may be a risk factor for developing a separate ipsilateral PJI.