Risk factors of reinfection after prosthesis removal and antibiotic bone cement spacer implantation for the treatment of periprosthetic joint infection

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Prosthesis removal and antibiotic bone cement spacer implantation is a very important link in two-stage revision of periprosthetic joint infection (PJI) after artificial joint replacement, which is key to the smooth progress of second-stage revision surgery. There are few reports on the risk factors of reinfection after prosthesis removal and antibiotic bone cement spacer implantation for PJI. This study aimed to investigate the risk factors of reinfection after prosthesis removal and antibiotic bone cement spacer implantation for the treatment of PJI.

Methods

Clinical data of 40 patients who underwent prosthesis removal and antibiotic bone cement spacer implantation for PJI after arthroplasty in our hospital from January 2013 to July 2019 were retrospectively analyzed. During the follow-up period of at least 2 years, 21 patients underwent complete two-stage revision after the removal of the antibiotic bone cement spacer, and 19 patients did not receive a new prosthesis due to other factors, such as reinfection or the patient’s wishes, record the infection control of patients during the treatment. Reinfection after prosthesis removal and antibiotic bone cement spacer implantation was defined as failure of effective control of infection, symptoms of reinfection, requires increased antibiotic therapy or reoperation. Multivariate Cox proportional hazards model was used to analyze the risk factors associated with reinfection after prosthesis removal and antibiotic bone cement spacer implantation.

Results

Of the 40 patients, nine (22.5%) developed reinfection after prosthesis removal and antibiotic bone cement spacer implantation with a mean follow-up duration of 31 months, and multivariate analysis revealed that history of prior revision surgery (hazard ratio [HR] = 6.317, confidence interval [CI]: 1.495–26.700; p = 0.012) and presence of sinus tract before treatment (HR = 5.117, 95% CI: 1.199–21.828; p = 0.027) were independent risk factors for reinfection after prosthesis removal and antibiotic bone cement spacer implantation.

Conclusion

History of prior revision surgery and presence of sinus tract are two independent risk factors for reinfection in patients with PJI treated with prosthesis removal and antibiotic bone cement spacer implantation.

Related collections

Most cited references 28

Record: found
Abstract: found
Article: not found

Economic burden of periprosthetic joint infection in the United States.

Steven M. Kurtz, Edmund Lau, Heather Watson … (2012)

This study characterizes the patient and clinical factors influencing the economic burden of periprosthetic joint infection (PJI) in the United States. The 2001-2009 Nationwide Inpatient Sample was used to identify total hip and knee arthroplasties using International Classification of Diseases, Ninth Revision, procedure codes. The relative incidence of PJI ranged between 2.0% and 2.4% of total hip arthroplasties and total knee arthroplasties and increased over time. The mean cost to treat hip PJIs was $5965 greater than the mean cost for knee PJIs. The annual cost of infected revisions to US hospitals increased from $320 million to $566 million during the study period and was projected to exceed $1.62 billion by 2020. As the demand for joint arthroplasty is expected to increase substantially over the coming decade, so too will the economic burden of prosthetic infections. Copyright © 2012. Published by Elsevier Inc.

0 comments Cited 312 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Prosthetic joint infection risk after TKA in the Medicare population.

Daniel Berry, S L Kurtz, Kevin J Bozic … (2009)

The current risk of infection in contemporary total knee arthroplasty (TKA) as well as the relative importance of risk factors remains under debate as a result of the rarity of the complication and temporal changes in the treatment and prevention of infection. We therefore determined infection incidence and risk factors after TKA in the Medicare population. The Medicare 5% national sample administrative data set was used to identify and longitudinally follow patients undergoing TKA for deep infections and revision surgery between 1997 and 2006. Cox regression was used to evaluate patient and hospital characteristics. In 69,663 patients undergoing elective TKA, 1400 TKA infections were identified. Infection incidence within 2 years was 1.55%. The incidence between 2 and up to 10 years was 0.46%. Women had a lower risk of infection than men. Comorbidities also increased TKA infection risk. Patients receiving public assistance for Medicare premiums were at increased risk for periprosthetic joint infection (PJI). Hospital factors did not predict an increased risk of infection. PJI occurs at a relatively high rate in Medicare patients with the greatest risk of PJI within the first 2 years after surgery; however, approximately one-fourth of all PJIs occur after 2 years. Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

0 comments Cited 165 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Two-stage treatment of hip periprosthetic joint infection is associated with a high rate of infection control but high mortality.

M Sneller, J. D. Morris, Keith Berend … (2013)

Periprosthetic infection after total hip arthroplasty (THA) is a devastating complication. Reported rates of infection control range from 80% to 95% but mortality rates associated with treatment of infected THA are also substantial and we suspect underreported. For patients selected for two-stage treatment of infected THA we therefore determined (1) mortality; (2) rate of reimplantation; and (3) rate of reinfection. We identified 202 patients (205 hips) with infected primary or revision THA treated with a two-stage protocol between 1996 and 2009 in our prospectively collected practice registry. Patients underwent two-stage treatment for infection, including removal of all implants and foreign material with implantation of an antibiotic-laden cement spacer in the first stage followed by intravenous culture-specific antibiotics for a minimum of 6 weeks. Second-stage reimplantation was performed if erythrocyte sedimentation rate and C-reactive protein were trending toward normal and the wound was well healed. Thirteen patients (13 hips) were lost to followup before 24 months. The minimum followup in surviving patients was 24 months or failure (average, 53 months; range, 24-180 months). Fourteen patients (7%; 14 hips) died before reimplantation and two were not candidates because of medical comorbidities. The 90-day mortality rate after the first-stage débridement was 4% (eight patients). Of the 186 patients (189 hips) who underwent reimplantation, 157 (83%) achieved control of the infection. Including all patients who underwent the first stage, survival and infection control after two-stage reimplantation was 76%. Two-stage treatment of deep infection in primary and revision THA is associated with substantial mortality and a substantial failure rate from both reinfection and inability to perform the second stage. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

0 comments Cited 99 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Yi Jin: hnjinyimd@163.com

Journal

Journal ID (nlm-ta): BMC Infect Dis

Journal ID (iso-abbrev): BMC Infect Dis

Title: BMC Infectious Diseases

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2334

Publication date (Electronic): 5 December 2022

Publication date PMC-release: 5 December 2022

Publication date Collection: 2022

Volume: 22

Electronic Location Identifier: 905

Affiliations

[1 ]GRID grid.414011.1, ISNI 0000 0004 1808 090X, Department of Orthopaedics, , Henan University People’s Hospital, Henan Provincial People’s Hospital, ; No. 7, Weiwu Road, Zhengzhou, 450003 Henan Province China

[2 ]GRID grid.414011.1, ISNI 0000 0004 1808 090X, Department of Orthopaedics, , Henan Provincial People’s Hospital, Henan University People’s Hospital, Zhengzhou University People’s Hospital, ; No. 7, Weiwu Road, Henan Province 450003 Zhengzhou, China

Article

Publisher ID: 7908

DOI: 10.1186/s12879-022-07908-z

PMC ID: 9720970

PubMed ID: 36471324

SO-VID: 7571b484-b0a7-4c61-b301-575e0a0762b1

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 25 February 2022

Date accepted : 30 November 2022

Funding

Funded by: Key Scientific and Technological Projects in Henan Province

Award ID: 202102310113

Funded by: National Natural Science Foundation of China

Award ID: 82002840

Award ID: 82002300

Award Recipient : Qingkai Wang Jincheng Huang

Funded by: Henan Provincial and Ministry Co-construction Project

Award ID: SBGJ202102031

Custom metadata

ScienceOpen disciplines: Infectious disease & Microbiology

Keywords: arthroplasty,periprosthetic joint infection,antibiotic bone cement spacer,two-stage revision,risk factor

Data availability:

ScienceOpen disciplines: Infectious disease & Microbiology

Keywords: arthroplasty, periprosthetic joint infection, antibiotic bone cement spacer, two-stage revision, risk factor

Comments

Comment on this article

scite_

Smart Citations

Citing PublicationsSupportingMentioningContrasting

View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

Cited by 5

See all cited by

Most referenced authors 293

See all reference authors

Risk factors of reinfection after prosthesis removal and antibiotic bone cement spacer implantation for the treatment of periprosthetic joint infection

Read this article at

Abstract

Background

Methods

Results

Conclusion

Related collections

Quaternary ammonium surfactants as nanoparticles against infection

Most cited references 28

Economic burden of periprosthetic joint infection in the United States.

Prosthetic joint infection risk after TKA in the Medicare population.

Two-stage treatment of hip periprosthetic joint infection is associated with a high rate of infection control but high mortality.

Author and article information

Contributors

Journal

Affiliations

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 644

Cited by 5

Most referenced authors 293