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Incidence, Secular Trends, and Outcomes of Prosthetic Joint Infection: A Population-Based Study, Olmsted County, Minnesota, 1969–2007

Published online by Cambridge University Press:  02 January 2015

Geoffrey Tsaras ,
Douglas R. Osmon ,
Tad Mabry ,
Brian Lahr ,
Jennifer St. Sauveur ,
Barbara Yawn ,
Robert Kurland  and
Elie F. Berbari
Geoffrey Tsaras*
Affiliation:
Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
Douglas R. Osmon
Affiliation:
Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
Tad Mabry
Affiliation:
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
Brian Lahr
Affiliation:
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
Jennifer St. Sauveur
Affiliation:
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota Rochester Epidemiology Project, Mayo Clinic, Rochester, Minnesota
Barbara Yawn
Affiliation:
Rochester Epidemiology Project, Mayo Clinic, Rochester, Minnesota Department of Medicine, Olmsted Medical Center, Rochester, Minnesota
Robert Kurland
Affiliation:
Department of Orthopedic Surgery, Olmsted Medical Center, Rochester, Minnesota
Elie F. Berbari
Affiliation:
Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
*
Department of Medicine, University of Illinois College of Medicine, 129 Phelps Avenue #508, Rockford, IL 61108 ([email protected])
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Abstract

Context.

The epidemiology of prosthetic joint infection (PJI) in a population-based cohort has not been studied in the United States.

Objectives.

To provide an accurate assessment of the true incidence, secular trends, clinical manifestations, microbiology, and treatment outcomes of PJI in a population-based cohort.

Design.

Historical cohort study.

Setting.

Olmsted County, Minnesota.

Participants.

Residents who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA) between January 1, 1969, and December 31, 2007.

Methods.

Incidence rates and trends in PJI were assessed using the Kaplan-Meier method and log-rank test, as were treatment outcomes among PJI case patients.

Results.

A total of 7,375 THAs or TKAs were implanted in residents of Olmsted County during the study period. Seventy-five discrete joints in 70 individuals developed PJI, during a mean ± SD follow-up of 6.8 ± 6.1 years. The cumulative incidence of PJI was 0.5%, 0.8%, and 1.4% after 1, 5, and 10 years after arthroplasty, respectively. Overall, the rate of survival free of clinical failure after treatment of PJI was 76.8% (95% confidence interval [CI], 64.3–85.2) and 65.2% (95% CI, 33.1–76.2) at 3 and 5 years, respectively. The incidence and treatment outcomes did not significantly differ by decade of implantation, patient age at implantation, gender, or joint location.

Conclusions.

The incidence of PJI is relatively low in a population-based cohort and is a function of age of the prosthesis. Incidence trends and outcomes have not significantly changed over the past 40 years.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 12 , December 2012 , pp. 1207 - 1212
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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References

1.Kurtz, S, Mowat, F, Ong, K, Chan, N, Lau, E, Halpern, M. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am 2005;87:1487–1497.Google Scholar
2.Kurtz, S, Ong, K, Lau, E, Mowat, F, Halpern, M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007;89:780–785.Google Scholar
3.Berbari, EF, Hanssen, AD, Duffy, MC, et al.Risk factors for prosthetic joint infection: case-control study. Clin Infect Dis 1998;27:1247–1253.Google Scholar
4.Herbert, CK, Williams, RE, Levy, RS, Barrack, RL. Cost of treating an infected total knee replacement. Clin Orthop 1996;140–145.Google Scholar
5.Sculpo, TP. The economic impact of infected total joint arthroplasty. Instr Course Lect 1993;42:349–351.Google Scholar
6.Wilson, MG, Kelley, K, Thornhill, T. Infection as a complication of total knee-replacement arthroplasty: risk factors and treatment in 67 cases. J Bone Joint Surg Am 1990;72(6):878–883.Google Scholar
7.Fitzgerald, RH JrNolan, DR, Ilstrup, DM, Van Scoy, RE, Washington, JA IICoventry, MB. Deep wound sepsis following total hip arthroplasty. J Bone Joint Surg Am 1977;59:847–855.Google Scholar
8.Insall, J, Scott, WN, Ranawat, CS. The total condylar knee prostheses: a report of two hundred and twenty cases. J Bone Joint Surg Am 1979;61:173–180.Google Scholar
9.Petty, W, Bryan, RS, Coventry, MB, Peterson, LF. Infection after total knee arthroplasty. Orthop Clin North Am 1989;20:201–210.Google Scholar
10.Wymenga, AB, van Horn, JR, Theeuwes, A, Muytjens, HL, Slooff, TJ. Peri-operative factors associated with septic arthritis after arthroplasty: prospective multicenter study of 362 knee and 2651 hip operations. Acta Orthop Scand 1992;63:665–671.Google Scholar
11.Rand, JA, Fitzgerald, RH JrDiagnosis and management of the infected total knee arthroplasty. Orthop Clin North Am 1989;20:201–210.Google Scholar
12.Bengston, S, Knutson, K. The infected knee arthroplasty: a 6-year follow up of 357 cases. Acta Orthop Scand 1991;62:301–311.Google Scholar
13.Melton, LJ. History of the Rochester Epidemiology Project. Mayo Clin Proc 1996;71:266–274.Google Scholar
14. US Census Bureau. Olmsted County QuickFacts. http://quickfacts.census.gov/qfd/states/27/27109.html. Accessed December 13, 2008.Google Scholar