Hepatitis B Virus Infection Is a Risk Factor for Periprosthetic Joint Infection Among Males After Total Knee Arthroplasty

Kuo, Sheng‐Fong; Huang, Po‐Hua; Chang, Chien-Chun; Kuo, Feng-Chih; Wu, Cheng-Ta; Hsu, Horng‐Chaung; Lin, Chun‐Pin

doi:10.1097/md.0000000000003806

Cited by 16 publications

(10 citation statements)

References 8 publications

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“…Notably, none of the patients developed bleeding complications. Furthermore, no revision surgeries for treatment of wound or periprosthetic joint infection were necessary, although the diagnosis of haemophilia with concomitant hepatitides constitutes a known risk factor and although the infection rate after TAR is documented to be 2%‐8.6% . Only few other studies discussing septic complications after TAR in haemophilic patients can are available for comparison.…”

Section: Discussionmentioning

confidence: 99%

Mid‐ to long‐term results of total ankle replacement in patients with haemophilic arthropathy: A 10‐year follow‐up

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Mid‐ to long‐term results of total ankle replacement in patients with haemophilic arthropathy: A 10‐year follow‐up

et al. 2017

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“…In our review of the literature, we identified only three studies that described outcomes of patients with HBV infection treated with arthroplasty. [12][13][14] Kuo et al 12 reported that HBV infection was a risk factor for periprosthetic joint infection (PJI) following TKAs among men, and Wang et al 13 demonstrated that HBV infection is an independent risk factor for complications of the arthroplasty operation. Kildow et al 14 demonstrated that patients with HBV had increased risk of pneumonia, sepsis, joint infection, and revision surgery at 90 days and two years following arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of primary total knee arthroplasty in patients with hepatitis B virus infection

et al. 2022

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Aims The purpose of this study was to compare the clinical outcomes, mortalities, implant survival rates, and complications of total knee arthroplasty (TKA) in patients with or without hepatitis B virus (HBV) infection over at least ten years of follow-up. Methods From January 2008 to December 2010, 266 TKAs were performed in 169 patients with HBV (HBV group). A total of 169 propensity score–matched patients without HBV were chosen for the control group in a one-to-one ratio. Then, the clinical outcomes, mortalities, implant survival rates, and complications of TKA in the two groups were compared. The mean follow-up periods were 11.7 years (10.5 to 13.4) in the HBV group and 11.8 years (11.5 to 12.4) in the control group. Results The mean Knee Society scores in the HBV and control groups improved from 37.1 (SD 5.6) and 38.4 (SD 5.4) points preoperatively to 78.1 (SD 10.8) and 81.7 (SD 10.2) points at final follow-up (p = 0.314), while the mean function scores in the HBV and control groups improved from 36.2 and 37.3 points preoperatively to 77.8 and 83.2 points at final follow-up (p = 0.137). Nine knees in the HBV group required revision surgery, including seven due to septic loosening and two due to aseptic loosening. Four knees in the control group required revision surgery, including three due to septic loosening and one due to aseptic loosening. Kaplan–Meier survivorship analysis with the revision of either component as an endpoint in the HBV and control groups estimated 96.6% and 98.5% chances of survival for ten years, respectively (p = 0.160). Conclusion TKA in patients with HBV infection resulted in good clinical outcomes and survivorship. However, there was a higher revision rate over a minimum ten-year follow-up period compared to TKA in patients without HBV infection. Cite this article: Bone Jt Open 2022;3(6):470–474.

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“…We have demonstrated a statistically significant increased risk of PJI in patients with a pre-operative confirmation of a genitourinary infection[10,27], nasal S. Aureus and MRSA infections[31], or other distant organ infections[6], such as hepatitis B[44]. …”

Section: Discussionmentioning

confidence: 99%

“…We believe that if a patient is known to have systemic infection, or a localised infection but distant to the operative joint, the risk of haematological spread of infection to the implant is highly likely. We have demonstrated a statistically significant increased risk of PJI in patients with a pre-operative confirmation of a genitourinary infection[ 10 , 27 ], nasal S. Aureus and MRSA infections[ 31 ], or other distant organ infections[ 6 ], such as hepatitis B[ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Predicting lower limb periprosthetic joint infections: A review of risk factors and their classification

George

Drago

Scarponi

et al. 2017

WJO

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AIMTo undertook a systematic review to determine factors that increase a patient’s risk of developing lower limb periprosthetic joint infections (PJI).METHODSThis systematic review included full-text studies that reviewed risk factors of developing either a hip or knee PJI following a primary arthroplasty published from January 1998 to November 2016. A variety of keywords were used to identify studies through international databases referencing hip arthroplasty, knee arthroplasty, infection, and risk factors. Studies were only included if they included greater than 20 patients in their study cohort, and there was clear documentation of the statistical parameter used; specifically P-value, hazard ratio, relative risk, or/and odds ratio (OR). Furthermore a quality assessment criteria for the individual studies was undertaken to evaluate the presence of record and reporting bias.RESULTSTwenty-seven original studies reviewing risk factors relating to primary total hip and knee arthroplasty infections were included. Four studies (14.8%) reviewed PJI of the hip, 3 (11.21%) of the knee, and 20 (74.1%) reviewed both joints. Nineteen studies (70.4%) were retrospective and 8 (29.6%) prospective. Record bias was identified in the majority of studies (66.7%). The definition of PJI varied amongst the studies but there was a general consensus to define infection by previously validated methods. The most significant risks were the use of preoperative high dose steroids (OR = 21.0, 95%CI: 3.5-127.2, P < 0.001), a BMI above 50 (OR = 18.3, P < 0.001), tobacco use (OR = 12.76, 95%CI: 2.47-66.16, P = 0.017), body mass index below 20 (OR = 6.00, 95%CI: 1.2-30.9, P = 0.033), diabetes (OR = 5.47, 95%CI: 1.77-16.97, P = 0.003), and coronary artery disease (OR = 5.10, 95%CI: 1.3-19.8, P = 0.017).CONCLUSIONWe have highlighted the need for the provider to optimise modifiable risk factors, and develop strategies to limit the impact of non-modifiable factors.

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Hepatitis B Virus Infection Is a Risk Factor for Periprosthetic Joint Infection Among Males After Total Knee Arthroplasty

Cited by 16 publications

References 8 publications

Mid‐ to long‐term results of total ankle replacement in patients with haemophilic arthropathy: A 10‐year follow‐up

Mid‐ to long‐term results of total ankle replacement in patients with haemophilic arthropathy: A 10‐year follow‐up

Long-term outcomes of primary total knee arthroplasty in patients with hepatitis B virus infection

Predicting lower limb periprosthetic joint infections: A review of risk factors and their classification

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