Extended oral antibiotics improved infection-related outcomes after aseptic revision TKA
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According to published results, extended oral antibiotic prophylaxis after aseptic revision total knee arthroplasty yielded a sevenfold reduction in 90-day infection risk.
Brandon R. Bukowski, MD, and colleagues at Mayo Clinic, Rochester retrospectively compared outcomes of aseptic revision TKA in 267 patients who received extended oral antibiotic (EOA) prophylaxis with cases of aseptic revision TKA in 637 patients who received no EOAs. According to the study, mean duration of EOA therapy was 11 days after surgery. Outcome measures included cumulative probability of infection, periprosthetic joint infection (PJI), superficial infection, as well as re-revision or reoperation for infection.
Overall, the cumulative probability of any infection after aseptic revision TKA was 1.9% at 90 days, 3.5% at 1 year and 8.1% at 5 years. At 90 days, patients who did not receive EOA had an increased risk of an infection (HR = 7.1); however, no increased risk was seen among this cohort at 1 year (HR = 1.1) or all-time (HR = 0.8). Additionally, the cumulative probability of PJI after aseptic revision TKA was 0.8% at 90 days, 2.3% at 1 year and 6.5% at 5 years. No differences in risk of PJI, re-revision or reoperation were seen between the cohorts at any time point, the researchers noted.
“PJI remains a major mode of failure following aseptic revision TKA, with considerable morbidity and mortality for patients and a substantial economic cost to the health care system,” the researchers wrote in the study. “Our results suggest a potential role for EOA after aseptic revision TKA and warrant additional prospective studies evaluating the relationship between EOA and infection-related outcomes,” they concluded.
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