Younger Age Is Associated with a Higher Risk of Early Periprosthetic Joint Infection and Aseptic Mechanical Failure After Total Knee Arthroplasty

Meehan, John P.; Danielsen, Beate; Kim, Sunny H; Jamali, Amir A.; White, Richard

doi:10.2106/jbjs.m.00545

Cited by 186 publications

(145 citation statements)

References 26 publications

(25 reference statements)

Supporting

Mentioning

132

Contrasting

Unclassified

Order By: Relevance

“…The OR of 1.9 may be of clinical importance but not significant as a result of the small number of PJIs and inadequate statistical power. The correlation between age and PJI has been a matter of controversy, with some reports mentioning young age as a risk factor for PJI 4,21 and some otherwise. 22 In our study, age was not associated with PJI occurrence.…”

Section: Discussionmentioning

confidence: 99%

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

Siu

Ng²,

Chan

et al. 2018

Hong Kong Med J

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

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

Siu

Ng²,

Chan

et al. 2018

Hong Kong Med J

View full text Add to dashboard Cite

“…2014). In another study, young age was found to impair the prognosis of TKA and was associated with increased revision rates for non-infectious reasons (Julin et al.…”

Section: Discussionmentioning

confidence: 99%

Different incidences of knee arthroplasty in the Nordic countries

et al. 2017

View full text Add to dashboard Cite

Background and purposeThe annual number of total knee arthroplasties (TKAs) has increased worldwide in recent years. To make projections regarding future needs for primaries and revisions, additional knowledge is important. We analyzed and compared the incidences among 4 Nordic countriesPatients and methodsUsing Nordic Arthroplasty Register Association (NARA) data from 4 countries, we analyzed differences between age and sex groups. We included patients over 30 years of age who were operated with TKA or unicompartmental knee arthroplasty (UKA) during the period 1997–2012. The negative binomial regression model was used to analyze changes in general trends and in sex and age groups.ResultsThe average annual increase in the incidence of TKA was statistically significant in all countries. The incidence of TKA was higher in women than in men in all 4 countries. It was highest in Finland in patients aged 65 years or more. At the end of the study period in 2012, Finland’s total incidence was double that of Norway, 1.3 times that of Sweden and 1.4 times that of Denmark. The incidence was lowest in the youngest age groups (< 65 years) in all 4 countries. The proportional increase in incidence was highest in patients who were younger than 65 years.InterpretationThe incidence of knee arthroplasty steadily increased in the 4 countries over the study period. The differences between the countries were considerable, with the highest incidence in Finland. Patients aged 65 years or more contributed to most of the total incidence of knee arthroplasty.

show abstract

“…Patients undergoing TKA at a younger age are likely to have diagnoses other than osteoarthritis and might have comorbidities that predisposed them to be candidates for TKA at a younger age like morbid obesity, rheumatoid arthritis, etc [12,25]. Meehan et al [20] showed that patients younger than 50 years are more likely to undergo revision as a result of PJI or aseptic mechanical failure at 1 year after TKA. Similarly, the higher rates of AKA in older populations could be the result of differences in comorbidities and/or patient preferences [13].…”

Section: Discussionmentioning

confidence: 99%

Racial Disparities in Above-knee Amputations After TKA: A National Database Study

George

Navale

Schiltz

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Above-knee amputation (AKA) is a rare but devastating complication of TKA. Although racial disparities have been previously reported in the utilization of TKA, it is unclear whether disparities exist in the rates of AKA after TKA. Questions/purposes (1) Which gender-racial group has the highest rate of AKA from septic and aseptic complications of TKA? (2) Which age groups have higher rates of AKA from septic and aseptic complications of TKA? Methods Using National Inpatient Sample data from 2000 to 2011, AKAs resulting from complications of TKA were identified using a combination of International Classification of Diseases, 9th Revision procedure and diagnosis codes. Of the 341,954 AKAs identified, 9733 AKAs were the result of complications of TKA (septic complications = 8104, aseptic complications = 1629). Standardized AKA rates were calculated for different age and gender-racial groups by dividing the number of AKAs in each group with the corresponding number of TKAs. Standardized rate ratios were calculated after adjusting for demographics and comorbidities. Results After adjusting for age and comorbidities, black men had the highest rate of AKA after TKA (adjusted rate in black men = 578 AKAs per 100,000 TKAs, standardized rate ratio [SRR] = 4.32 [confidence interval {CI},.82], p \ 0.001). Black men also had the highest rate of AKA after septic complications of TKA (p \ 0.001). The adjusted rates of AKA were higher in patients younger than 50 years (adjusted rate = 473, SRR = 3.14 [CI, 2.94-3.36], p \ 0.001) and older than 80 years (adjusted rate = 297, SRR = 1.85 [CI, 1.76-1.95], p \ 0.001). Conclusions The rising demand for TKA has led to an increase in the number of AKAs performed for complications of TKA in the United States. Although we did not find an increase in the rate of AKA during the study period, certain populations, including black men and patients older than 80 years and younger than 50 years, had higher rates of AKA. Further studies are required to understand the reasons for these disparities and measures should be undertaken to eliminate these disparities. Level of Evidence Level III, therapeutic study.

show abstract

Younger Age Is Associated with a Higher Risk of Early Periprosthetic Joint Infection and Aseptic Mechanical Failure After Total Knee Arthroplasty

Abstract: Patients younger than fifty years of age had a significantly higher risk of undergoing revision due to periprosthetic joint infection or to aseptic mechanical failure at one year after primary total knee arthroplasty.

Cited by 186 publications

References 26 publications

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

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

Different incidences of knee arthroplasty in the Nordic countries

Racial Disparities in Above-knee Amputations After TKA: A National Database Study

Contact Info

Product

Resources

About