Prior Joint Infection Raises Future Infection Risk 3x

For patients who have had the misfortune of experiencing a prosthetic joint infection (PJI) after primary total knee arthroplasty (TKA) or total hip arthroplasty (THA), what is their risk of having another prosthetic joint infection in another TKA?

A recent study addressing this, “Prior hip or knee prosthetic joint infection in another joint increases risk three-fold of prosthetic joint infection after primary total knee arthroplasty: a matched control study,” appears in the June 30, 2019 edition of The Bone and Joint Journal.

Researchers from Mayo Clinic in Rochester, Minnesota, retrospectively reviewed 95 patients (102 primary TKAs) treated between 2000 and 2014 with a history of prosthetic joint infection in another TKA or THA and found that 27% of the patients were on chronic antibiotic suppression.

Co-author Matthew P. Abdel, M.D., professor of Orthopedic Surgery at the Mayo Clinic College of Medicine and director of the Orthopedic Genetic Host Variation Laboratory at that institution explained the underlying hypothesis of the study to OTW, “Oftentimes, patients present with end-stage degenerative arthritis mandating a total knee arthroplasty (TKA), yet they have a previous history of prosthetic joint infection in a contralateral TKA, ipsilateral THA, or contralateral THA. The natural question is, ‘What is the risk of prosthetic joint infection in this TKA I am about to complete?’”

“In this matched cohort study, we found patients undergoing a clean primary TKA with history of TKA or THA PJI in another joint had a three-fold higher risk of PJI compared with matched controls with ten-year cumulative incidence of 6.1%. The risk of prosthetic joint infection was 15-fold higher in patients on chronic antibiotic suppression; further investigation into reasons for this and mitigation strategies are recommended.”