Estimating incidence rates of periprosthetic joint infection after hip and knee arthroplasty for osteoarthritis using linked registry and administrative health data

Abstract

Aims The aim of this study was to estimate the 90-day periprosthetic joint infection (PJI) rates following total knee arthroplasty (TKA) and total hip arthroplasty (THA) for osteoarthritis (OA). Methods This was a data linkage study using the New South Wales (NSW) Admitted Patient Data Collection (APDC) and the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), which collect data from all public and private hospitals in NSW, Australia. Patients who underwent a TKA or THA for OA between 1 January 2002 and 31 December 2017 were included. The main outcome measures were 90-day incidence rates of hospital readmission for: revision arthroplasty for PJI as recorded in the AOANJRR; conservative definition of PJI, defined by T84.5, the PJI diagnosis code in the APDC; and extended definition of PJI, defined by the presence of either T84.5, or combinations of diagnosis and procedure code groups derived from recursive binary partitioning in the APDC. Results The mean 90-day revision rate for infection was 0.1% (0.1% to 0.2%) for TKA and 0.3% (0.1% to 0.5%) for THA. The mean 90-day PJI rates defined by T84.5 were 1.3% (1.1% to 1.7%) for TKA and 1.1% (0.8% to 1.3%) for THA. The mean 90-day PJI rates using the extended definition were 1.9% (1.5% to 2.2%) and 1.5% (1.3% to 1.7%) following TKA and THA, respectively. Conclusion When reporting the revision arthroplasty for infection, the AOANJRR substantially underestimates the rate of PJI at 90 days. Using combinations of infection codes and PJI-related surgical procedure codes in linked hospital administrative databases could be an alternative way to monitor PJI rates. Cite this article: Bone Joint J 2022;104-B(9):1060–1066.

No clinical difference at mid-term follow-up between TiN-coated versus uncoated cemented mobile-bearing total knee arthroplasty: a matched cohort study

“…It has also been suggested that ceramic surfaces could be more resistant to biofilm formation and reduce the risk of chronic periprosthetic joint infections. However, this theoretical advantage has not been observed in registry studies [ 18 , 31 ]. The TiN surface is also thought to facilitate interdigitation between the implant and the bone cement [ 7 ].…”

Design and Retrospective Cohort Validation of an Algorithm for Surgical Site Infection Surveillance after Hip Replacement Surgery Using Natural Language Processing and Extreme Gradient Boosting

“…Thirdly, at present, our model can only be used for SSI detection in patients undergoing hip replacement. Although the unbalanced nature of our sample required the use of weights to ensure a high negative predictive value, the overall prevalence of hip prosthetic joint infection in the general population (1•3% to 2•2%) 22 is similar to that of our sample, indicating that our model could be used successfully in other centers, although further validation is needed.…”

Intraosseous regional prophylactic antibiotics decrease the risk of infection in total knee arthroplasty compared with intravenous antibiotics: a systematic review and meta-analysis

“…The main causes of survival and efficacy for the joint replacement prosthesis include poor force line of the lower extremities, infection, aseptic loosening of the prosthesis, and anterior pain ( 12 ). Among them, prosthetic infection is with an incidence rate of 0.69–2.2% ( 13 , 14 ). Once infection occurs, it requires surgery and long-term use of antibiotics to be treated, and treatment failure is common.…”