Concomitant Multiple Joint Arthroplasty Infections: Report on 16 Cases

Zeller, Valérie; Dedome, Delphine; Lhotellier, Luc; Graff, Wilfrid; Desplaces, Nicole; Marmor, Simon

doi:10.1016/j.arth.2016.02.012

Cited by 11 publications

(14 citation statements)

References 18 publications

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“…First, we analyzed only patients with a hematogenous PJI who had at least 1 other prosthetic joint in situ. However, it is known that patients with a history of PJI have a higher chance of having a second PJI, especially during an episode of bacteremia [14][15][16]. Thus, even in this "high-risk" group, the chance of having a PJI in an asymptomatic joint at the time of having a hematogenous PJI is very low.…”

Section: Discussionmentioning

confidence: 99%

“…Timely diagnosis is thus of extreme importance. Patients who are diagnosed with a PJI and who have concomitant prosthetic joints in situ appear to have the highest risk for having a second PJI [14][15][16]. Therefore, we retrospectively analyzed a cohort of patients with hematogenous PJI who also had 1 or more concomitant prosthetic joints in situ at the time of PJI diagnosis.…”

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confidence: 99%

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How to Handle Concomitant Asymptomatic Prosthetic Joints During an Episode of Hematogenous Periprosthetic Joint Infection, a Multicenter Analysis

Wouthuyzen-Bakker

Sebillotte

Arvieux

et al. 2020

Clinical Infectious Diseases

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Background Prosthetic joints are at risk of becoming infected during an episode of bacteremia, especially during Staphylocococcus aureus bacteremia. However, it is unclear how often asymptomatic periprosthetic joint infection (PJI) occurs, and whether additional diagnostics should be considered. Methods In this multicenter study, we retrospectively analyzed a cohort of patients with a late acute (hematogenous) PJI between 2005–2015 who had concomitant prosthetic joints in situ. Patients without at least 1 year of follow-up were excluded. Results We included 91 patients with a hematogenous PJI and 108 concomitant prosthetic joints. The incident PJI was most frequently caused by Staphylococcus aureus (43%), followed by streptococci (26%) and Gram-negative rods (18%). Of 108 concomitant prosthetic joints, 13 were symptomatic, of which 10 were subsequently diagnosed as a second PJI. Of the 95 asymptomatic prosthetic joints, 1 PJI developed during the follow-up period and was classified as a “missed” PJI at the time of bacteremia with S. aureus (1.1%). Infected prosthetic joints were younger than the noninfected ones in 67% of cases, and prosthetic knees were affected more often than prosthetic hips (78%). Conclusions During an episode of hematogenous PJI, concomitant asymptomatic prosthetic joints have a very low risk of being infected, and additional diagnostic work-up for these joints is not necessary.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

How to Handle Concomitant Asymptomatic Prosthetic Joints During an Episode of Hematogenous Periprosthetic Joint Infection, a Multicenter Analysis

Wouthuyzen-Bakker

Sebillotte

Arvieux

et al. 2020

Clinical Infectious Diseases

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“…Only five studies reported series of synchronous or both synchronous and metachronous periprosthetic joint infections in which the data concerning synchronous infections were clearly distinguishable [ 4 , 5 , 6 , 7 , 8 ] ( Table 1 , Table 2 , Table 3 , Table 4 and Table 5 ). Three further studies were considered as reporting data on multiple PJIs [ 10 , 11 , 12 ] ( Table 5 ).…”

Section: Resultsmentioning

confidence: 99%

“…Zeller et al [ 4 ] found 16 (1.4%) patients with synchronous PJI in a cohort of 1185 patients affected by PJIs. PJIs involved bilateral total hip arthroplasty (THA) in eight patients, bilateral total knee arthroplasty (TKA) in three patients, one THA and TKA in four patients.…”

Section: Resultsmentioning

confidence: 99%

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Synchronous Periprosthetic Joint Infections: A Scoping Review of the Literature

et al. 2022

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Prosthetic joint infections (PJIs) occurring in multiple joints at the same time (synchronous PJI) are an extremely rare complication, frequently associated with bacteremia, and are associated with high mortality rates. The presence of three or more prosthetic joints, rheumatoid arthritis, neoplasia, bacteremia and immune-modulating therapy seem to be the recurring risk factors for synchronous PJI. In case of PJIs, all other replaced joints should be considered as potentially infected and investigated if PJI is suspected. Treatments of synchronous multiple PJIs vary and must be decided on a case-by-case basis. However, the advantages of one-stage exchange seem to outweigh the two-stage protocol, as it decreases the number of necessary surgical procedures. Nonetheless, too few studies have been conducted to allow firm conclusions about the best handling of synchronous PJI. Thus, additional studies are needed to understand this devastating complication and to design the most appropriate diagnostic and therapeutic path.

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