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Updated: May 7, 2026
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Timing and Trends of Periprosthetic Joint Infections Following Over 1,500,000 Primary and Revision Total Knee and Hip
Maxwell T Trudeau1, Eric Wang1, Olivia Schaffer1
1NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY, USA.
Background:
Periprosthetic joint infections (PJIs) following primary and revision total knee arthroplasty (rTKA) and revision total hip arthroplasty (rTHA) have been studied, but a contemporary large-scale analysis of incidence has not been performed. This study assessed PJI incidence and trends for TKA, THA, rTKA, and rTHA using a contemporary database.
Methods:
Epic Cosmos database was retrospectively queried (2015-2023). Current procedureal terminology codes identified patients: 27447 (TKA), 27130 (THA), 27486 (rTKA one component), 27487 (rTKA both components), 27134 (rTHA both components), 27137 (rTHA acetabular component), and 27138 (rTHA femoral component). PJI rates were identified using International Classification of Diseases 9/10 codes and analyzed using linear regression.
Results:
A total of 1,658,742 cases were identified: 962,967 TKA, 600,225 THA, 59,212 rTKA, and 36,338 rTHA. PJI rates for TKA were 0.25% (30 days) and 1.19% (1 year). PJI rates for THA were 0.46% (30 days) and 1.28% (1 year). One-year PJI rates from 2015 to 2023 decreased 17% for TKA and 40% for THA (P = .001). The 1-year PJI rate for rTKA (all types) was 6.51%, differing between one-component (9.34%) and both components (4.68%) (P = .001). The 1-year PJI rate for rTHA (all types) was 8.78%, differing between both-components (8.79%), acetabular component (8.62%), and femoral component (8.88%) (P = .01). One-year PJI rates were not correlated with year of surgery for rTKA or rTHA (P = .43, P = .08).
Conclusions:
Significant PJI reduction after primary TKA and THA was observed over the last decade, but infection rates remained stable in revision cohorts. Further investigations are required to assess underlying reasons for observed PJI rate reductions following primary arthroplasty.
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