Periprosthetic Joint Infection Following Total Knee Arthroplasty Is Associated with a Significantly Elevated Risk of...

Area of Science:

• Orthopedic Surgery
• Infection Control
• Public Health

Background:

• Periprosthetic joint infection (PJI) is a primary cause for revision total knee arthroplasty (TKA).
• Early PJI (within 1 year) after total hip arthroplasty is linked to increased 10-year mortality.
• This study investigates long-term mortality differences in TKA patients with and without early PJI.

Purpose of the Study:

• To compare 10-year mortality rates in TKA patients who developed PJI within one year versus those who did not.
• To analyze the long-term survival outcomes associated with early PJI after TKA.

Main Methods:

• Retrospective population-level database study utilizing a single-payer healthcare system.
• Propensity-score matching was employed to compare mortality between patients with and without PJI within one year post-TKA.
• Primary outcome was 10-year mortality; 1- and 5-year mortality rates were also assessed.

Main Results:

• 0.5% of 263,204 primary TKA patients developed PJI within one year.
• PJI patients were more likely male, frail, and had comorbidities like CHF and COPD.
• Matched analysis revealed a significantly higher 10-year mortality rate for TKA patients with early PJI (7.2%) compared to those without (1.6%).

Conclusions:

• Early PJI following TKA is associated with a substantially increased risk of 10-year mortality.
• The underlying reasons for this elevated mortality risk require further investigation.
• Enhanced strategies for PJI prevention, diagnosis, and management are crucial.