背景:全髋关节置换术(THA)或全膝关节置换术(TKA)的假体周围感染(PJIs)可能发生在未感染的同侧假体关节的环境中。然而,未感染的同侧关节的风险未知.我们分析了同侧膝关节或髋关节PJI治疗后,在有风险的THA和TKA中没有PJI的幸存者,分别。
方法:使用我们的机构总联合注册表,我们确定了205例接受PJI治疗的患者(123THA和83TKA)有同侧原位膝关节或髋关节风险,分别,2000年至2019年。总的来说,54%的PJIs指数是慢性的,46%是急性的。平均年龄是70岁,47%是女性,平均体重指数为32。进行Kaplan-Meier生存分析。平均随访6年。
结果:患侧TKA治疗PJI后,在高危THA中无PJI的5年生存率为97%。当同侧THA接受PJI治疗时,在高危TKA中无PJI的5年生存率为99%。发生了三个PJI(2个THA和1个TKA),从指数同侧PJI治疗开始超过1年。一次髋关节PJI是由肺炎引起的急性血源性感染。其他2个新的PJI是由与索引PJI相同的生物引起的,并且是由于索引接头处的源控制失败所致。
结论:在单关节诊断为PJI时,同侧假体关节在5年内发生PJI的风险较低(风险为1%~3%).在罕见的同侧感染事件中,所有病例均发生在从PJI指数开始超过1年的时间,并且在源感染控制失败时,3个中的2个是相同的生物体.
方法:预后III级。
BACKGROUND: Periprosthetic joint infections (PJIs) of total hip arthroplasty (THA) or total knee arthroplasty (TKA) may occur in the setting of an uninfected ipsilateral prosthetic joint. However, the risk to that uninfected ipsilateral joint is unknown. We analyzed the survivorship free from PJI in at risk THAs and TKAs following treatment of an ipsilateral knee or hip PJI, respectively.
METHODS: Using our institutional total joint registry, we identified 205 patients who underwent treatment for PJI (123 THAs and 83 TKAs) with an at-risk ipsilateral in situ knee or hip, respectively, between 2000 and 2019. In total, 54% of index PJIs were chronic and 46% were acute. The mean age was 70 years, 47% were female, and the mean body mass index was 32. Kaplan-Meier survivorship analyses were performed. Mean follow-up was 6 years.
RESULTS: The 5-year survivorship free of PJI in an at-risk THA after an ipsilateral TKA was treated for PJI was 97%. The 5-year survivorship free of PJI in an at-risk TKA when the ipsilateral THA was treated for PJI was 99%. Three PJIs occurred (2 THAs and 1 TKA), all over 1 year from the index ipsilateral PJI treatment. One hip PJI was an acute hematogenous infection that resulted from pneumonia. The other 2 new PJIs were caused by the same organism as the index PJI and were due to a failure of source control at the index joint.
CONCLUSIONS: When diagnosed with PJI in a single joint, the risk of developing PJI in an ipsilateral prosthetic joint within 5 years was low (1 to 3% risk). In the rare event of an ipsilateral infection, all occurred greater than one year from the index PJI and 2 of 3 were with the same organism when source infection control failed.
METHODS: Prognostic Level III.