Bacteriology and risk factors associated with periprosthetic joint infection after primary total knee arthroplasty: retrospective study of 2543 cases

Siu, Kin-Fun; Ng, FY; Chan, Ping Keung; Fu, Henry; Yan, Chun Hoi; Chiu, K. Y.

doi:10.12809/hkmj176885

Cited by 8 publications

(8 citation statements)

References 21 publications

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“…Our centre had demonstrated a similar survival rate of 94.2% at 10 years. Revision and combined infection rates were both low at 6.4% and 4.4% at 10 years of follow-up, respectively, similar to other local data 20,21 and international data. 5 The most common reasons for revision arthroplasty in current literature are infection and aseptic loosening.…”

Section: Discussionsupporting

confidence: 88%

“…25,26 Current literature had suggested that co-morbidity such as diabetes, anaemia, thyroid disease, heart disease, lung disease, liver disease and rheumatoid arthritis could result in increased infection risk. 18,21,26 Other factors that could increase infection risk include long operating time, 16,18 younger age, allogeneic blood transfusion 26 and posterior-stabilised implant. 27 In this study, operative duration of arthroplasty which had subsequent revision (mean 115.7 mins) was significantly longer than cases without subsequent revision (mean 97.4 mins) ( p = 0.01).…”

Section: Discussionmentioning

confidence: 99%

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Total knee arthroplasty: A single centre review at 10 years of follow-up

Tse

Wan

Leung

et al. 2020

Journal of Orthopaedics, Trauma and Rehabilitation

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Background: Total knee arthroplasty is a common procedure for treatment of various non-infective arthritis. This study reviewed total knee arthroplasty cases up to 10 years of follow-up for the survival rate, reasons of revision and associated perioperative risk factors for revision. Methods: All cases to total knee arthroplasty performed in a single centre in the years 2007 and 2008 were reviewed. A total of 227 cases of total knee arthroplasty were performed during the 2-year period, with 156 cases followed up to 10 years. Perioperative information, follow-up information and information of possible complications were obtained. Results: The survival rate of total knee arthroplasty in this study is 98.2% at 5 years and 94.2% at 10 years of follow-up. The early post-operative complication rate was low, and majority of cases had improvement of function at 1 year after the operation. Early post-operative infection rate was low at 0.4%, and overall infection up to 10 years of follow-up was also low at 4.4%. Ten cases had undergone revision of arthroplasty by 10 years after operation. Conclusion: The survival rate of total knee replacement was high. The revision rate and infection rates were low up to 10 years of follow-up. The most common reasons of revision arthroplasty were infection and aseptic loosening. Cases which required revision arthroplasty had significantly longer operative duration compared with cases without revision at 10 years of follow-up ( p = 0.01).

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Total knee arthroplasty: A single centre review at 10 years of follow-up

Tse

Wan

Leung

et al. 2020

Journal of Orthopaedics, Trauma and Rehabilitation

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“…In another study from a center with similar demographics, a longer operative team in the initial arthroplasty is related to subsequent revision arthroplasty. 30 In a recent local study, Siu et al 31 stated that gram positive Staphylococcus was most common infective organism. Similarly in this study, infective organism identified were predominately gram positive cocci (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Revision total knee arthroplasty longer term outcome and comparison between infection and aseptic loosening at mean follow-up of 10 years

Tse

Hui

et al. 2020

Journal of Orthopaedics, Trauma and Rehabilitation

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Background: Although the majority of total knee arthroplasty cases have good outcome and survival, some arthroplasty eventually required revision. While early outcomes of revision knee arthroplasty are well reported, there is relatively fewer literatures reporting on the longer term outcome of revision knee arthroplasty. This study aims to review the outcome of revision knee arthroplasty for a longer term, and also make comparison between the two common indications for revision arthroplasty of infection and aseptic loosening. Methods: This study reviews all total knee arthroplasty revision performed at a single center over a 11 year period. Of the 48 cases found, 35 cases not lost to follow-up had a mean follow-up duration of 10.6 years (SD 2.9) for aseptic loosening, and 10.1 years (SD 2.6) for infection. Data of initial arthroplasty, revision arthroplasty, demographics, follow-up outcome were obtained, analyzed and compared. Results: Revision arthroplasty due to infection had more cases that required use of varus/valgus constraints (p ∼ 0.008) and extensile surgical exposure of quadriceps snip (p ∼ 0.005) compared to aseptic loosening. The survival at 10 years for this study is 91% overall (aseptic loosening 93.3%, infection 89.3%). Infection cases had significant initial improvement for range of motion (p ∼ 0.001) and use of walking aid (p ∼ 0.04) at post-operation 1 year, but no significant differences between the infection and aseptic loosening cases at 5 years and 10 years follow-up. Comparison between the two groups on other factors including initial arthroplasty, operative details, demographics, post-operative details and X-rays showed no statistically significant difference.

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“…3,7,10,11 A review of 2543 primary total knee arthroplasties (TKA) found that the PJI rate in RA was 3.1%, which was significantly higher than 1.2% in non-RA patients. 12 The reason for the increased risk in rheumatoid patients has several folds. Firstly, they are commonly on immunosuppressive medications which delay wound healing and impair immune responses.…”

Section: Rheumatologic Diseasesmentioning

confidence: 99%

Preoperative optimization to prevent periprosthetic joint infection in at-risk patients

Chan

et al. 2020

J Orthop Surg (Hong Kong)

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Periprosthetic joint infection (PJI) remains an important complication with devastating consequences after total joint arthroplasties. With the increasing number of arthroplasties worldwide, the number of PJI will increase correspondingly with a significant economic burden to our healthcare system. It is likely impossible to completely eradicate PJI; hence, assessment and optimization of its risk factors to preventing such a disastrous complication will be the key. There are many strategies to prevent PJI in the preoperative, intraoperative, or postoperative phases. The preoperative assessment provides a unique opportunity to screen and diagnose underlying comorbidities and optimize modifiable risk factors before elective surgeries. In this review, we will focus on current literature in preoperative assessment of various modifiable risk factors and share the experience and practical approach in our institution in preoperative optimization to reduce PJI in total joint arthroplasties.

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Bacteriology and risk factors associated with periprosthetic joint infection after primary total knee arthroplasty: retrospective study of 2543 cases

Cited by 8 publications

References 21 publications

Total knee arthroplasty: A single centre review at 10 years of follow-up

Total knee arthroplasty: A single centre review at 10 years of follow-up

Revision total knee arthroplasty longer term outcome and comparison between infection and aseptic loosening at mean follow-up of 10 years

Preoperative optimization to prevent periprosthetic joint infection in at-risk patients

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