Incidence and risk factors of prosthetic joint infection after total hip or knee replacement in patients with rheumatoid arthritis |
| |
| Authors: | Tim Bongartz Christine S. Halligan Douglas R. Osmon Megan S. Reinalda William R. Bamlet Cynthia S. Crowson Arlen D. Hanssen Eric L. Matteson |
| |
| Affiliation: | 1. Mayo Clinic College of Medicine, Rochester, Minnesota;2. Dr. Bongartz has received consultant fees, speaking fees, and/or honoraria (more than $10,000) from Wyeth, and educational grants (more than $10,000) from Amgen.;3. Dr. Matteson has received consultant fees (less than $10,000 each) from Abbott and Amgen, and grants (more than $10,000 each) from Wyeth and Amgen. |
| |
| Abstract: | Objective Prosthetic joint infection is one of the most dreaded complications after total joint arthroplasty, a common procedure in patients with rheumatoid arthritis (RA). We conducted a study to evaluate potential risk factors of prosthetic joint infection and to clarify if RA is an independent predictor of this complication. Methods This study included all patients with RA who underwent total hip or knee replacement at the Mayo Clinic Rochester between January 1996 and June 2004. The association of potential risk factors with prosthetic joint infection was examined using Cox models. A matched cohort of patients with osteoarthritis (OA) was assembled to determine whether RA is an independent risk factor for prosthetic joint infection. Results We identified 462 patients with RA who underwent a total of 657 hip or knee replacements. Overall, 23 (3.7%) joint arthroplasties were complicated by an infection during a mean ± SD followup of 4.3 ± 2.4 years. Revision arthroplasty (hazard ratio [HR] 2.99, 95% confidence interval [95% CI] 1.02–8.75) and a previous prosthetic joint infection of the replaced joint (HR 5.49, 95% CI 1.87–16.14) were significant predictors of postoperative prosthetic joint infection. Comparison of RA patients with a matched cohort of OA patients identified an increased risk of prosthetic joint infections (HR 4.08, 95% CI 1.35–12.33) in patients with RA. Conclusion Patients with RA who undergo total hip or knee replacement are at increased risk of prosthetic joint infection, which is further increased in the setting of revision arthroplasty and a previous prosthetic joint infection. These findings highlight the importance of perioperative prophylactic measures and vigilance during the postoperative period. |
| |
| Keywords: | |
|
|
