Lower prosthetic joint infection rate seen with aspirin thromboprophylaxis vs other agents
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Results of a study showed aspirin was linked with lower rates of early, deep prosthetic joint infection after primary total knee arthroplasty vs. non-aspirin chemoprophylaxis, a presenter said.
In a presentation at the Musculoskeletal Infection Society Annual Meeting, Vinay K. Aggarwal, MD, of NYU Langone Health, said, “Our analysis demonstrated that the use of aspirin for [venous thromboembolism] VTE prophylaxis following primary total knee arthroplasty is independently associated with a lower rate of early prosthetic joint infections. Therefore, we believe that arthroplasty surgeons should strongly consider aspirin as the gold-standard chemoprophylaxis in all patients in which it is deemed medically appropriate.”
Aggarwal and colleagues reviewed all patients at their hospital who developed PJI, as defined by the 2018 Musculoskeletal Infection Society criteria, within 90 days of TKA surgery performed from 2013 to 2019. Of the 11,547 patients who met the inclusion criteria, 4,941 patients (42.8%) had non-aspirin chemoprophylaxis administered postoperatively and 6,606 patients (57.2%) had aspirin-exclusive chemoprophylaxis administered postoperatively, Aggarwal said. Researchers conducted various analyses to determine independent risk factors and predictors of PJI after TKA.
“There was a statistically significant difference in the age, BMI, Charlson Comorbidity Index and the past medical history of VTE rates between our two cohorts,” Aggarwal said when he discussed one univariate analysis that was done.
“We then performed a univariate analysis for risk factors of PJI and found that age, BMI, Charlson Comorbidity Index, non-aspirin chemoprophylaxis, male gender and a history of diabetes were significant predictors of periprosthetic joint infection after TKA,” he said.
The multivariate logistic regression researchers did based on these univariate analyses showed a significantly lower odds of PJI among patients who were given aspirin exclusively as VTE chemoprophylaxis, according to the abstract.
When adjusted for confounding variables, the OR of the aspirin group for developing PJI was 0.542; 95% CI, 0.305-0.944. “This was statistically significant, with a P value of .033,” Aggarwal said.
In further advice based on the findings to surgeons who perform TKA, he said, ”They should carefully weigh the morbidity of periprosthetic joint infection in patients where non-aspirin chemoprophylaxis is considered.”
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Anil U, et al. Paper 812. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 6-7, 2021; Fort Lauderdale, Florida (hybrid meeting) .
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