Periprosthetic Joint Infection Is the Main Cause of Failure for Modern Knee Arthroplasty: An Analysis of 11,134 Knees

Koh, Chuan Kong; Zeng, Irene; Ravi, Saiprassad; Zhu, Mark; Vince, Kelly G.; Young, Simon W.

doi:10.1007/s11999-017-5396-4

Cited by 251 publications

(137 citation statements)

References 27 publications

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“…In our country, the infection rate of knee arthroplasties is higher than those reported in other countries [4,17,18]. The data of infection rates in primary TKA presented in arthroplasty registers from some countries show infection rates less than 2% [19][20][21] , in our country it is around 2% [17].…”

Section: Discussioncontrasting

confidence: 45%

Risk factors for periprosthetic joint infection after total knee arthroplasty in Spanish population

Melchor

Planchard

Mendoza

et al. 2019

Preprint

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Background: Periprosthetic joint infection (PJI) is the most serious and feared complication in total knee arthroplasty (TKA) and can have catastrophic consequences. The number of total knee arthroplasties has increased and will continue to increase so that the number of infections will also be greater in the future. The aim of this study is to identify the most relevant risk factors associated with infection after a total knee prosthesis in a Spanish population. Methods: This is a case-control study of patients who underwent total knee arthroplasty at the University Hospital of Salamanca during the period January 1 2010 until January 1, 2015. TKA PJI was detected in 66 patients. As controls, a similar number of patients from the same period who did not develop a periprosthetic infection were included. Demographic and clinical variables were collected. A descriptive and inferential analysis was performed. Results: Diabetes, ASA grade, obesity and the use or not of antibiotic loaded cement were statistically significant related to the appearance of the infection. For the variables of surgical time and ischemia time, this relationship disappeared when the logistic regression was made. Conclusions: Our study provides evidence that diabetes, cement type, ASA and BMI were independently associated with increased risk of PJI for TKA patients in a Spanish population. We think that modifiable risk factors were specifically relevant and for that reason we can reduce the infection rate.

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Section: Discussioncontrasting

confidence: 45%

Risk factors for periprosthetic joint infection after total knee arthroplasty in Spanish population

Melchor

Planchard

Mendoza

et al. 2019

Preprint

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“…Infections are the leading cause of revisions after total joint arthroplasty (TJA) . They are associated with devastating patient outcomes, require expertize from several specialties, and confer a tremendous financial burden .…”

mentioning

confidence: 99%

In‐Room Ultraviolet Air Filtration Units Reduce Airborne Particles During Total Joint Arthroplasty

Anis

Curtis

Klika

et al. 2019

Journal Orthopaedic Research

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Reducing airborne bioburden in total joint arthroplasty (TJA) is of critical importance. The efficacy of crystalline ultraviolet-C (C-UVC) filtration in reducing bioburden in a dynamic operating room (OR) environment has not been evaluated. We assessed whether C-UVC filtration reduced (i) total particle counts (TPC); (ii) viable particle counts (VPC); and (iii) colony-forming units (CFUs). Fifty primary TJA cases were performed in a positive-pressure OR; 25 cases with the C-UVC unit and 25 cases without. The air was sampled by a particle counter and an impact air sampler to measure particle counts and CFUs, respectively. To compare TPC, VPC, and CFU/m 3 between groups, independent t tests and multivariate regression, adjusted for number of OR staff and door openings, were performed. The C-UVC group had significantly lower TPC (2.6 × 10 6 vs. 4.7 × 10 6 particles, p = 0.001) and VPC (18,605 vs. 27,516 particles, p = 0.001). There were fewer CFUs in the C-UVC group (10.9 CFU/m 3 vs. 13.7 CFU/m 3 , p = 0.163). Multivariate analysis identified C-UVC filtration as a significant predictor of decreased TPC (β = −0.44, p = 0.002) and VPC (β = −0.47, p = 0.001) after accounting for door openings and number of OR staff. The reduction in CFUs was not significant on multivariate analysis. In this prospective pilot study, a C-UVC air disinfection and recirculation unit led to a significant reduction in both TPC and VPC and a non-significant reduction in CFU. Statement of clinical significance: Further studies are needed to investigate the effects of C-UVC filtration units on surgical-site infection rates.

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“…The incidence is unfortunately higher for revision THA (1.6 to 3.96% at 1–2 years; [5,6]) and revision TKA (0.9% in the first 30 days and 4.6% at 2 years [7,8•]). Furthermore, PJI is the most common reason for revision TKA and is the second most common reason for revision THA, accounting for 24–30% of TKA revision and 11–30% of THA revisions [5,9–11]. The morbidity of undergoing revision surgery for PJI should not be underestimated.…”

Section: Quantifying the Burden Of Periprosthetic Joint Infectionmentioning

confidence: 99%

Current Options and Emerging Biomaterials for Periprosthetic Joint Infection

et al. 2018

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Recent advancements in local antibiotic delivery platforms for preventing and treating PJI include titanium nanotube arrays, synthetic polymers, resorbable hydrogels, and cyclodextrin-based drug delivery options. In particular, cyclodextrins have facilitated great advancements in other clinical disorders and have demonstrated early promise as a future option in the arena of PJI. Novel treatment modalities for PJI optimize the implant surfaces to prevent bacterial biofilm formation or provide prolonged intra-articular antibiotic dosing to eradicate bacteria.

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Periprosthetic Joint Infection Is the Main Cause of Failure for Modern Knee Arthroplasty: An Analysis of 11,134 Knees

Abstract: Level III, therapeutic study.

Cited by 251 publications

References 27 publications

Risk factors for periprosthetic joint infection after total knee arthroplasty in Spanish population

Risk factors for periprosthetic joint infection after total knee arthroplasty in Spanish population

In‐Room Ultraviolet Air Filtration Units Reduce Airborne Particles During Total Joint Arthroplasty

Current Options and Emerging Biomaterials for Periprosthetic Joint Infection

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