Study finds decreasing rates of multiple PJIs

Issue: September 2013

PHILADELPHIA — The prevalence of developing a second periprosthetic joint infection in patients who have had multiple arthroplasties was found to be significantly lower than previously reported studies, according to a presenter here.

“It was a retrospective cohort study, and we may have lost patients to follow-up, but we feel it was the largest series of patients at risk of multiple periprosthetic joint infections and it reflects more modern treatment,” John P. Haverstock, MD, said.

The investigators performed an institutional database search of patients with multiple hip and knee joint arthroplasties who had subsequent surgery for infection. Patients who developed a second infection of a different joint were studied to determine the pathogen, timing of infection and other risk factors.

John P. Haverstock

In all, 499 patients were identified as having surgery for infection, with 206 patients with multiple arthroplasties having at least one surgery for infection. Of these, 14 (6.7%) patients had a second periprosthetic joint infection. Nine patients had bilateral knee infections, with three patients having bilateral hip infections. One patient had an ipsilateral hip and knee infection, and one patient had infections in both hips and one knee. The first infection was most often classified as a late chronic infection with Staphylococcus aureus was the most common pathogen. Six secondary infections were polymicrobial.

Reference:

Haverstock JP. Multiple periprosthetic joint infections: Evidence for decreasing prevalence. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 2-3, 2013; Philadelphia.

Disclosure: Haverstock has no relevant financial disclosures; however, some co-authors received institutional research support from DePuy, Smith & Nephew and Stryker.