Extended follow-up of patients suspected of having joint sepsis after total joint replacement

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Biostatistics

Background:

• Total joint replacement is a common procedure for debilitating arthritis.
• While generally successful, prosthetic joint infection remains a serious complication.
• Long-term outcomes and the incidence of late-onset infections require further investigation.

Purpose of the Study:

• To investigate the incidence and outcomes of suspected joint infections following total hip or knee replacement.
• To assess the rate of late-onset infections and their impact on joint function.
• To compare infection rates in patients with suspected infections to matched controls.

Main Methods:

• Retrospective analysis of 8052 patients undergoing total hip or knee replacement.
• Detailed review of hospital records for 72 patients with suspected joint infections.
• Extended follow-up averaging 5 years to assess long-term complications and outcomes.

Main Results:

• Among 72 patients with suspected infections, 35 experienced major joint problems, with 18 requiring revision surgery.
• Confirmed infection was present in 17 of the 35 patients with complications.
• The incidence of confirmed infection was approximately three times higher than in matched controls.
• Late-onset infections (2.5-7 years post-op) were as frequent as early infections (<2.5 years).
• Non-infectious failure rates reached approximately 5% by 7 years post-operation.

Conclusions:

• Suspected joint infections after total joint replacement are associated with significant long-term morbidity and revision rates.
• Late-onset prosthetic joint infections are a considerable concern, occurring as frequently as early-onset infections.
• These findings highlight the importance of vigilant monitoring for infection throughout the lifespan of prosthetic joints.