No significant difference in PJI risk seen for colonoscopy 6 months before vs. after TJA
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Key takeaways:
- Timing of colonoscopy before or after total joint arthroplasty was not associated with periprosthetic joint infection risk.
- It is important to consider these results when developing clinical practice guidelines.
SAN FRANCISCO — Results presented here showed timing of colonoscopy relative to total joint arthroplasty was not linked to an increased risk of periprosthetic joint infection.
“When trying to schedule colonoscopy screening, as well as elective arthroplasty, it is important to weigh the risks and benefits and to optimize the timing of this period for doing these types of interventions for our patients. But ultimately, we found no difference in complications with PJI for patients with preoperative or postoperative colonoscopy,” Ashley B. Anderson, MD, LT, MC, USN, of Walter Reed National Military Medical Center, said in her presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “This is important to note when scheduling these patients and developing clinical practice guidelines.”
Using the Military Health System Data Repository, Anderson and colleagues retrospectively reviewed data on patients older than 45 years who underwent colonoscopy screening either 6 months before (n=11,482) or after (n=7,496) total hip or knee arthroplasty. The outcome of interest included presence of PJI within 1 year after TJA among patients who had a colonoscopy within 6 months before TJA and presence of PJI within 1 year after colonoscopy index date among patients who had a colonoscopy within 6 months after TJA.
“We did a multivariable analysis to look for risk factors associated with the colonoscopy status,” Anderson said. “We also did sensitivity analysis to see if there was an association between time, procedure and arthroplasty type.”
Anderson said patients had a PJI incidence rate of 2.8% if they underwent colonoscopy prior to TJA and of 1.8% if they underwent colonoscopy after TJA. An adjusted model showed timing of preoperative and postoperative colonoscopy was not associated with PJI risk.
“Looking at the frequencies of PJI, there was no association between timing between colonoscopy procedures and arthroplasty,” Anderson said. “This was not different when stratifying by arthroplasty type.”
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Anderson AB, et al. Paper 297. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
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