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  • Following total hip...

Following total hip replacement, septic hip arthritis linked to higher risk of periprosthetic joint infection

Written By : Dr. Kamal Kant Kohli Published On 2022-11-27T20:00:46+05:30  |  Updated On 28 Nov 2022 11:13 AM IST
Following total hip replacement, septic hip arthritis linked to higher risk of periprosthetic joint infection
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BALTIMORE: According to a study that was published in The Journal of Arthroplasty, there is a substantial risk of periprosthetic joint infection post total hip arthroplasty if there has been less than a one-year interval of quiescence following septic arthritis of the hip.

Each year, 20,000 people are given the diagnosis of septic arthritis, with 15% of those cases especially impacting the hip joint. These circumstances aggravate arthritic changes, frequently necessitating a total hip replacement (THA). These patients are more likely to develop periprosthetic joint infections as a result of their past infection history (PJIs).

The authors aimed to compare a group of THA patients without a history of septic hip to individuals who were diagnosed with septic hip arthritis at intervals (0 to 6, or 6 to 12 months) before an ipsilateral initial THA. They specifically evaluated (1) PJI-related changes from 90 days to 2 years and (2) risk variables for PJI at 2 years.

For this objective, A national, all-payer database was searched to find all patients who underwent a primary THA between 2010 and 2021, and patients who had previously experienced ipsilateral septic hip arthritis were identified (n = 1,052) using codes from the International Classification of Disease and Current Practice Terminology. As a non-septic group comparison, a randomized sample of patients (n = 5000) who had never previously experienced septic arthritis was used. The occurrences of PJI at 90 days through two years were then determined and compared using bivariate chi-square analysis. Multivariate regression models were then used to examine risk factors for post-THA PJIs.

Conclusive highlights of the study:

  • At 90 days, a year, and two years (all p <0.0001), the cohorts with septic arthritis were more likely than the non-septic group to need modifications as a result of PJIs.
  • In comparison to patients who had diagnoses between 6 and 12 months prior to THA, patients who had septic arthritis diagnoses between 0 and 6 months prior to THA had a higher risk of developing PJI at both one and two years (odds ratio (OR) of 43.1 versus 29.6, p<0.0001 and OR of 38.3 versus 22.1, p<0.0001).
  • In comparison to the population without a history of septic hip, diabetes mellitus, obesity, and cigarette use were linked risk factors for PJIs at 2-years in the cohort with a septic hip.

The authors came to the conclusion that, between 0 and 6 months and between 6 and 12 months, respectively, a shorter than 1-year quiescent period following septic arthritis is linked with a 38- and 22-fold greater risk for post-THA PJI, respectively. Although the risks are lower for patients who undergo THA more than 6 months after their septic arthritis treatment than for those who do so between 0 and 6 months after treatment, they are still substantial.

Orthopaedic surgeons should be mindful of the elevated risks of PJIs when considering a THA in patients with a history of septic arthritis.

REFERENCE

Jeremy A. Dubin et.al., Less than 1-year quiescent period after septic arthritis of the hip is associated with high risk of periprosthetic joint infection following total hip arthroplasty. November 24, 2022 DOI:https://doi.org/10.1016/j.arth.2022.11.004

total hip replacementseptic hip arthritisperiprosthetic joint infectionThe Journal of Arthroplastyquiescencepast infection history
Source : The Journal of Arthroplasty
Dr. Kamal Kant Kohli
Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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