Measuring Outcomes: Pain and Quality of Life 48 Months After Acute Postoperative Total Knee Prosthetic Joint Infection

Núñez, Montserrat; Vílchez-Cavazos, Félix; Juárez, Esther Núñez; Martínez-Pastor, Juan C.; Beneyto, Francisco Maculé; Suso, S.; Viladomiu, Àlex Soriano

doi:10.1111/papr.12214

Cited by 6 publications

(1 citation statement)

References 22 publications

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“…In this study, early PJI and achieving a clinical cure of the infection were associated with a successful functional outcome. Previous studies with smaller cohorts have also shown favorable functional outcomes in patients with early PJI, particularly when DAIR was used 25,26 . This highlights the management challenges in treating late-acute and chronic PJI and underscores the importance of early identification and treatment initiation for patients with early PJI.…”

Section: Discussionmentioning

confidence: 90%

Patient-Reported Outcomes Following Periprosthetic Joint Infection of the Hip and Knee

Manning,

Rofe,

Athan

et al. 2024

Journal of Bone and Joint Surgery

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Background: The role of patient-reported outcome measures (PROMs) as tools for monitoring the impact and outcomes of periprosthetic joint infection (PJI) is not well described. This study analyzed the Oxford Hip Score (OHS) or Oxford Knee Score (OKS) in a prospective observational cohort of patients with hip or knee PJI. Methods: The PIANO (Prosthetic joint Infection in Australia and New Zealand, Observational study) cohort prospectively enrolled patients with newly diagnosed PJI from multiple centers. The OHS and OKS were evaluated at PJI diagnosis (baseline) and at 3, 12, and 24 months. Scores and score changes were examined according to PJI type, patient characteristics, and management. A successful functional outcome at 12 months was defined as an OHS of >38 or OHS of >36 and/or an improvement from baseline of >12 or >9, respectively. Results: Of the 741 participants, PROMs were available at 12 months for 233 with hip and 342 with knee PJI. Significant improvements (p < 0.0001) were seen at 12 months for both the OHS (24.5 to 36) and OKS (25 to 34), with no further improvement at 24 months. Patients with late-acute PJI had a higher median baseline OHS (35; interquartile range [22 to 46]) and OKS (30 [18 to 41]) than those with early PJI (OHS: 19 [15 to 29]; OKS: 22 [16 to 29.5]) or chronic PJI (OHS: 23 [14 to 34]; OKS 22 [14 to 28]). Logistic regression showed that a clinical cure (adjusted odds ratio [aOR] = 1.88, 95% confidence interval [CI] = 1.28 to 2.76, p = 0.001) and early PJI (aOR = 2.56, 95% CI = 1.64 to 4.07, p < 0.0001) independently predicted a successful functional outcome. Chronic renal impairment (aOR = 0.31, 95% CI = 0.13 to 0.71, p = 0.007), congestive cardiac failure (aOR = 0.41, 95% CI = 0.17 to 0.95, p = 0.04), and clinical signs of inflammation (aOR = 0.53, 95% CI = 0.33 to 0.85, p = 0.009) at diagnosis independently predicted failure to achieve a successful functional outcome. Conclusions: The OHS and OKS varied significantly at baseline and 12 months according to PJI type, emphasizing the need to consider the PJI type when evaluating treatment success. This study highlights superior functional outcomes associated with early PJI and with achievement of a clinical cure. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 90%

Patient-Reported Outcomes Following Periprosthetic Joint Infection of the Hip and Knee

Manning,

Rofe,

Athan

et al. 2024

Journal of Bone and Joint Surgery

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Good quality of life outcomes after treatment of prosthetic joint infection with debridement and prosthesis retention

et al. 2015

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Patients treated for early prosthetic joint infection (PJI) with surgical debridement and prosthesis retention have a rate of successful infection eradication that is similar to patients treated with the traditional approach of prosthesis exchange. It is therefore important to consider other outcomes after prosthetic joint infection treatment that may influence management decisions, such as quality of life (QOL). Our aim was to describe infection cure rates and quality of life for patients with prosthetic joint infection treated with debridement and prosthesis retention and to determine if treatment with this approach was a risk factor for poor quality of life outcomes. Prospectively collected pre and post-arthroplasty data were available for 2,134 patients, of which PJI occurred in 41. For patients treated for prosthetic joint infection, the 2-year survival free of treatment failure was 87% (95%CI 84-89). Prosthetic joint infection cases treated with debridement and retention had a similar improvement from pre-arthroplasty to 12-months postarthroplasty as patients without PJI in QOL according to the SF-12 survey. Prosthetic joint infection treated with debridement and retention was not a risk factor for poor quality of life on univariate or multivariate analysis. Prosthetic joint infection treated with debridement and prosthesis retention results in good cure rates and quality of life. Further studies are required that directly compare quality of life for different surgical approaches for prosthetic joint infection to better inform management decisions.

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Epidemiology of Prosthetic Joint Infection

Benito

Esteban

Horcajada

et al. 2017

Prosthetic Joint Infections

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Measuring Outcomes: Pain and Quality of Life 48 Months After Acute Postoperative Total Knee Prosthetic Joint Infection

Abstract: Health-related quality-of-life measures detected significant differences in outcomes in patients infected by S. aureus compared with patients infected by other microorganisms. HRQOL measures may provide useful complementary information on outcomes after acute postoperative infection.

Cited by 6 publications

References 22 publications

Patient-Reported Outcomes Following Periprosthetic Joint Infection of the Hip and Knee

Patient-Reported Outcomes Following Periprosthetic Joint Infection of the Hip and Knee

Good quality of life outcomes after treatment of prosthetic joint infection with debridement and prosthesis retention

Epidemiology of Prosthetic Joint Infection

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