Background: The risk of periprosthetic joint infection (PJI) is higher in persons who inject drugs (PWID) after total joint arthroplasty (TJA), though reported rates vary widely. This study was designed to assess outcomes of TJA in PWID and to describe factors associated with improved PJI outcomes among PWID.
Methods: A retrospective matched cohort study was performed using a 1:4 match among those with and those without a history of injection drug use (IDU) undergoing TJA. Demographic, surgical, and outcome variables were compared in multivariate logistic regressions to determine PJI predictors. Kaplan-Meier analyses were constructed to characterize the difference in survival of patients who did not have PJI or undergo joint explantation between PWID and the matching cohort.
Results: PWID had a 9-fold increased risk of PJI compared to the matched cohort (odds ratio 9.605, 95% CI 2.781-33.175, P < .001). Ten of 17 PWID whose last use was within 6 months (active use) of primary TJA had a PJI, while 7 of 41 PWID who did not have active use developed a PJI. Of PWID with PJI, treatment failure was seen in 15 of 17, while in patients who did not have an IDU history, 5 of 8 with PJI had treatment failure.
Conclusion: IDU is a significant risk factor for PJI following TJA. Future work investigating the effect of a multidisciplinary support team to assist in cessation of IDU and to provide social support may improve outcomes and reduce morbidity in this vulnerable population.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979100 | PMC |
| http://dx.doi.org/10.1016/j.arth.2022.07.018 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Pathogenesis of prosthetic joint infections: bacterial adhesion and internalization in osteoblasts, synoviocytes and endothelial cells.
J Med Microbiol
January 2025
Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS Lyon, Lyon 1 University, Lyon, France.
is frequently isolated during prosthetic joint infections (PJIs). Unlike , its internalization and persistence within cells are controversial. We aimed to determine whether internalization is involved in the pathophysiology of PJIs.
View Article and Find Full Text PDFIncidence and Presentation of Periprosthetic Joint Infection After Primary Metacarpophalangeal and Proximal Interphalangeal Arthroplasty.
J Hand Surg Am
January 2025
Mayo Clinic Department of Orthopedic Surgery, 4500 San Pablo Road Jacksonville, FL. Electronic address:
Purpose: Periprosthetic joint infection (PJI) is a devastating complication that has been extensively investigated in large joint arthroplasty. However, this has been inconsistently reported after metacarpophalangeal (MCP) and proximal interphalangeal (PIP) arthroplasty. The objective of the study was to report the presentation and treatment of patients with PJI after MCP or PIP joint arthroplasty.
View Article and Find Full Text PDFHow Often Does Bacteremia Occur in Patients With Chronic Periprosthetic Joint Infection? A Prospective, Observational Study.
Clin Orthop Relat Res
January 2025
Department of Orthopedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, PR China.
Background: Bacteremia is sometimes observed in patients with prosthetic joint infection (PJI), and it is associated with a lower likelihood of infection control. However, the prevalence and association of bacteremia in chronic PJI remain unknown.
Questions/purposes: (1) What percentage of patients are diagnosed with bacteremia at the time of hospital admission and before surgery for chronic PJI? (2) What clinical factors are associated with positive blood cultures? (3) To what degree are positive blood cultures associated with infection-free implant survival in patients with chronic PJI?
Methods: This prospective study was conducted at a single academic institution from June 2021 to August 2022.
Outcomes of Total Joint Arthroplasty in Patients Who Have Ehlers-Danlos Syndrome: A Systematic Review and Meta-Analysis.
J Arthroplasty
January 2025
Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, 10021; Weill Cornell Medicine, New York, NY, 10021. Electronic address:
Background: Patients who have Ehlers-Danlos Syndrome (EDS), a group of connective tissue disorders characterized by aberrant collagen synthesis and processing, have an increased likelihood of requiring a total joint arthroplasty (TJA), including total hip or knee arthroplasty (THA or TKA). This study aimed to synthesize outcomes following TJA in patients who have EDS.
Methods: This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
ASA Class Is a Stronger Predictor of Early Revision Risk Following Primary Total Knee Arthroplasty than BMI.
JB JS Open Access
January 2025
School of Medicine, Rural Clinical School, University of Queensland, Toowoomba, Queensland, Australia.
Background: Although there is a known correlation between obesity and revision risk following total knee arthroplasty (TKA), there is an ongoing debate regarding the appropriateness of denying TKA solely based on the body mass index (BMI) of a patient. Our aim was to determine whether a patient's American Society of Anesthesiologists (ASA) class predicts their risks of early all-cause revision and revision for periprosthetic joint infection (PJI) following primary TKA, independent of their BMI.
Methods: Data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) were obtained regarding all patients who underwent primary TKA for osteoarthritis in Australia from January 1, 2015, to December 31, 2022.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!