Higher 2-Year Cumulative Incidence of Mental Health Disorders Following Antibiotic Spacer Placement for Chronic Periprosthetic Joint Infection following Total Joint Arthroplasty |
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| Institution: | 1. Department of Orthopaedic Surgery, George Washington School of Medicine and Health Sciences, Washington, District of Columbia;2. Johns Hopkins Department of Orthopaedic Surgery, Columbia, Maryland;3. Department of Orthopaedic Surgery, Penn Orthopaedics, Philadelphia, Pennsylvania;4. Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri;5. Department of Orthopaedic Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia;1. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;2. Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea;1. Dignity Health Medical Group, Arizona Creighton University School of Medicine- Phoenix, Phoenix, Arizona;2. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan;3. Northwell Health Orthopaedic Institute at Lenox Hill, New York, New York;4. Department of Orthopedic Surgery, St. Joseph Mercy Hospital, Ann Arbor, Michigan;1. Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China;2. Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China;3. Hunan Engineering Research Center for Osteoarthritis, Changsha, Hunan, China;4. National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China;5. Clinical Trial Unit, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China;6. China Standard Medical Information Research Center, Shenzhen, Guangdong, China;7. Health Management Center, Xiangya Hospital, Central South University, Changsha, Hunan, China |
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| Abstract: | BackgroundThe relationship of chronic periprosthetic joint infection (PJI) treatment on the development and relapse of mood disorders remains largely unreported. This study aims to compare the incidence of different mental health disorders following antibiotic spacer placement for chronic PJI when compared to aseptic revisions and primary procedures.MethodsPatients who underwent antibiotic spacer for septic total hip and knee arthroplasty (PJI THA/TKA) were identified in the PearlDiver Database using Current Procedure Terminology (CPT) codes for hip and knee antibiotic spacers. Patients who underwent aseptic revision and primary-THA/TKA were also identified using CPT codes. The incidences of depressive, anxiety, bipolar, psychotic, and stress disorders were identified within 2 years following the index procedures via Kaplan–Meier Analysis.ResultsThe risk of depressive (hazard ratio (HR): 1.5; P < .001) and stress (HR: 1.5; P < .001) disorders were significantly higher in those who underwent PJI-THA when compared to aseptic revision, with the added risk of bipolar when compared to primary THA. The risk of depressive (HR: 1.6; P < .001), stress (HR: 1.4; P < .001), bipolar (HR: 1.3; P < .001), and psychotic disorders (HR: 1.5; P = .003) were significantly higher in those who underwent PJI-TKA when compared to aseptic revision, with the added risk of anxiety when compared to primary TKA.ConclusionPatients who undergo spacer placement for septic-THA/TKA have a disproportionately higher incidence of mental health disorders within 2 years following surgery when compared those undergoing aseptic revisions and primary procedures. Due to this higher risk, physicians should strongly consider collaborative care with psychiatrists or mental health professionals.Level of EvidenceIII. |
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| Keywords: | periprosthetic joint infection depression anxiety total joint arthroplasty mental health |
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