Does use of a biologic agent increase the incidence of postoperative infection in surgery for rheumatoid arthritis after total joint arthroplasty?

Objectives: The goal of the study was to examine the influence of biological agents on postoperative infections such as surgical site infection (SSI) and late infection in patients with rheumatoid arthritis after total joint arthroplasty at our hospital between January 2006 and December 2011.

Methods: The patients were divided into groups with (Bio group, 267 joints) and without (Non-Bio group, 300 joints) treatment with biological agents. We examined the incidence of postoperative infection in Bio group and Non-Bio group. Multivariate logistic regression analysis was performed to identify the risk factor of postoperative infection.

Results: The incidences of superficial and deep SSI were 0.37% and 1.0%, respectively, in the Bio group, and 0.67% and 0%, respectively, in the Non-Bio group, with no significant difference between the two groups. The incidences of late infection were 1.0% and 0% in the Bio and Non-Bio groups, respectively, again with no significant difference between the groups. Multivariate logistic regression analysis revealed the following values for the surgery of the foot and ankle region [P = 0.001, odds ratio (OR) = 19.27; 95% confidence interval (CI) 4.67-79.45]. The use of biological agents was not a risk factor for postoperative infection.

Conclusions: These results suggest that the use of biological agents does not significantly increase the incidences of SSI and late infection after orthopedic surgery in patients with rheumatoid arthritis after total joint arthroplasty.