Patients undergoing TKA for native knee septic arthritis have increased risk of PJI
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Published results show that compared with patients undergoing total knee arthroplasty for osteoarthritis, patients who undergo the procedure for native knee septic arthritis have a 6.1-fold increased risk for periprosthetic joint infection.
Jacob W. Bettencourt, BS, and colleagues at the Mayo Clinic, Rochester retrospectively analyzed data from 215 primary TKAs indicated for the treatment of septic arthritis of the same native knee from 1971 to 2016. Researchers compared outcomes of this septic arthritis cohort with a matched, control cohort of 215 primary TKAs indicated for the treatment of OA. According to the study, outcome measures included survivorship, aseptic revision, periprosthetic joint infection (PJI), risk of subsequent infection and postoperative Knee Society Scores. Among the cohorts, mean patient age was 63 years and mean follow-up was 9 years.
The primary causative organism of native knee septic arthritis was a Staphylococcus species, which accounted for 45% of all septic arthritis cases. In the septic arthritis cohort, Bettencourt and colleagues found survivorship free of PJI at 10 years was 90%; survivorship free of any aseptic revisions at 10 years was 83%; and survivorship free of any reoperation at 10 years was 61%.
In the OA cohort, survivorship free of PJI at 10 years was 99%; survivorship free of any aseptic revisions at 10 years was 93%; and survivorships free of any reoperation at 10 years was 84%.
“There was a 6.1-fold increased risk of PJI in patients undergoing TKA with a history of native knee septic arthritis when compared with controls undergoing TKA for the treatment of OA, with a cumulative incidence of 9% at 10 years,” the researchers wrote in the study.
“Subgroup analysis of the septic arthritis cohort revealed a higher risk of any infection in patients who underwent TKA within the first 5 to 7 years after the diagnosis of septic arthritis as compared with those with a greater duration,” they added. “Surgeons can use these data to help guide and properly counsel patients preoperatively about potential complications and hopefully provide future direction for more precise treatment algorithms for patients with symptomatic OA in the setting of previous same-knee septic arthritis.”
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