Periprosthetic Knee and Hip Infection — Is It Possible to Compare Treatment Outcomes?
- 作者: Bozhkova S.A.1, Preobrazhensky P.M.1, Kochish A.A.1, Tikhilov R.M.1, Artyukh V.A.1, Klitsenko O.A.2
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隶属关系:
- Vreden National Medical Research Center of Traumatology and Orthopedics
- Mechnikov North-Western State Medical University
- 期: 卷 29, 编号 4 (2023)
- 页面: 5-13
- 栏目: Clinical studies
- URL: https://bakhtiniada.ru/2311-2905/article/view/255328
- DOI: https://doi.org/10.17816/2311-2905-15526
- ID: 255328
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详细
Background. It is known that the outcomes of patients treatment with periprosthetic joint infection (PJI) are significantly influenced by the state of the patient’s body, the nature of the pathogen, the state of tissues in the area of the infectious focus and the treatment tactics. However, topographic and anatomical features of the blood supply to the knee and hip joints, as well as the volume of soft tissues, can affect the spectrum of pathogens, manifestations of the infectious process and, as a consequence, the effectiveness of treatment.
The aim of the study was to conduct a comparative analysis of the somatic status of patients, the etiology of the infectious process and the effectiveness of treatment of PJI depending on its localization.
Methods. A single-center retrospective study was conducted. The cases of 337 patients were studied — 119 patients with knee and 218 patients with hip PJI who underwent treatment with a two-stage technique during the period from 2007 to 2017. A comparative analysis of the PJI pathogens structure and concomitant pathology between patients with hip and knee PJI was carried out. The frequency of infection relief in the groups following the first stage was counted.
Results. Recurrence was diagnosed four times more frequently in patients with hip PJI compared to knee PJI. Risk factors for recurrence were gram-negative pathogens, microbial associations, and fistulous forms of the infectious process. Localization of the infectious process in the hip area was associated with a statistically significant greater volume of blood loss during the prolonged debridement surgery.
Conclusion. Recurrences of PJI occur more frequently in the hip area compared to the knee joint. Further analysis of critical factors in recurrence development is necessary for potential intervention.
作者简介
Svetlana Bozhkova
Vreden National Medical Research Center of Traumatology and Orthopedics
Email: clinpharm-rniito@yandex.ru
ORCID iD: 0000-0002-2083-2424
Dr. Sci. (Med.)
俄罗斯联邦, St. PetersburgPetr Preobrazhensky
Vreden National Medical Research Center of Traumatology and Orthopedics
Email: pedrro@yandex.ru
ORCID iD: 0000-0002-9569-1566
Cand. Sci. (Med.)
俄罗斯联邦, St. PetersburgAndrey Kochish
Vreden National Medical Research Center of Traumatology and Orthopedics
编辑信件的主要联系方式.
Email: kochishman@gmail.com
ORCID iD: 0000-0001-8573-1096
Cand. Sci. (Med.)
俄罗斯联邦, St. PetersburgRashid Tikhilov
Vreden National Medical Research Center of Traumatology and Orthopedics
Email: rtikhilov@gmail.com
ORCID iD: 0000-0003-0733-2414
Dr. Sci. (Med.), Professor
俄罗斯联邦, St. PetersburgVasily Artyukh
Vreden National Medical Research Center of Traumatology and Orthopedics
Email: artyukhva@mail.ru
ORCID iD: 0000-0002-5087-6081
Dr. Sci. (Med.)
俄罗斯联邦, St. PetersburgOlga Klitsenko
Mechnikov North-Western State Medical University
Email: olkl@yandex.ru
ORCID iD: 0000-0002-2686-8786
Cand. Sci. (Biol.)
俄罗斯联邦, St. Petersburg参考
- Postler A., Lützner C., Beyer F., Tille E., Lützner J. Analysis of Total Knee Arthroplasty revision causes. BMC Musculoskelet Disord. 2018;19(1):55. doi: 10.1186/s12891-018-1977-y.
- Boelch S.P., Jakuscheit A., Doerries S., Fraissler L., Hoberg M., Arnholdt J. et al. Periprosthetic infection is the major indication for TKA revision – experiences from a university referral arthroplasty center. BMC Musculoskelet Disord. 2018;19(1):395. doi: 10.1186/s12891-018-2314-1.
- Premkumar A., Kolin D.A., Farley K.X., Wilson J.M., McLawhorn A.S., Cross M.B. et al. Projected Economic Burden of Periprosthetic Joint Infection of the Hip and Knee in the United States. J Arthroplasty. 2021;36(5): 1484-1489.e3. doi: 10.1016/j.arth.2020.12.005.
- Kurtz S.M., Higgs G.B., Lau E., Iorio R.R., Courtney P.M., Parvizi J. Hospital Costs for Unsuccessful Two-Stage Revisions for Periprosthetic Joint Infection. J Arthroplasty. 2022;37(2):205-212. doi: 10.1016/j.arth.2021.10.018.
- Rava A., Bruzzone M., Cottino U., Enrietti E., Rossi R. Hip Spacers in Two-Stage Revision for Periprosthetic Joint Infection: A Review of Literature. Joints. 2019;7(2):56-63. doi: 10.1055/s-0039-1697608.
- Kini S.G., Gabr A., Das R., Sukeik M., Haddad F.S. Two-stage Revision for Periprosthetic Hip and Knee Joint Infections. Open Orthop J. 2016;10:579-588. doi: 10.2174/1874325001610010579.
- Ермаков А.М., Клюшин Н.М., Абабков Ю.В., Тряпичников А.С., Коюшков А.Н. Оценка эффективности двухэтапного хирургического лечения больных с перипротезной инфекцией коленного и тазобедренного суставов. Гений ортопедии. 2018;24(3):321-326. doi: 10.18019/1028-4427-2018-24-3-321-326. Ermakov A.M., Kliushin N.M., Ababkov Iu.V., Triapichnikov A.S., Koiushkov A.N. Efficiency of two-stage revision arthroplasty in management of periprosthetic knee and hip joint infection. Genij Ortopedii. 2018;24(3): 321-326. doi: 10.18019/1028-4427-2018-24-3-321-326. (In Russian).
- Craig A., King S.W., van Duren B.H., Veysi V.T., Jain S., Palan J. Articular spacers in two-stage revision arthroplasty for prosthetic joint infection of the hip and the knee. EFORT Open Rev. 2022;7(2):137-152. doi: 10.1530/EOR-21-0037.
- Ren X., Ling L., Qi L., Liu Z., Zhang W., Yang Z. et al. Patients’ risk factors for periprosthetic joint infection in primary total hip arthroplasty: a meta-analysis of 40 studies. BMC Musculoskelet Disord. 2021;22(1):776. doi: 10.1186/s12891-021-04647-1.
- Kong L., Cao J., Zhang Y., Ding W., Shen Y. Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta-analysis. Int Wound J. 2017;14(3):529-536. doi: 10.1111/iwj.12640.
- Kunutsor S.K., Whitehouse M.R., Blom A.W., Beswick A.D. INFORM Team. Patient-Related Risk Factors for Periprosthetic Joint Infection after Total Joint Arthroplasty: A Systematic Review and Meta-Analysis. PLoS One. 2016;11(3):e0150866. doi: 10.1371/journal.pone.0150866.
- Parvizi J., Tan T.L., Goswami K., Higuera C., Della Valle C., Chen A.F. et al. The 2018 Definition of Periprosthetic Hip and Knee Infection: An Evidence-Based and Validated Criteria. J Arthroplasty. 2018;33(5):1309-1314.e2. doi: 10.1016/j.arth.2018.02.078.
- Преображенский П.М., Божкова С.А., Каземирский А.В. Расчет индекса коморбидности как фактора риска рецидива перипротезной инфекции после установки спейсера коленного сустава. Травматология и ортопедия России. 2022;28(1):7-18. doi: 10.17816/2311-2905-1718. Preobrazhensky P.M., Bozhkova S.A., Kazemirsky A.V. Comorbidity Index as a Risk Factor of Knee PJI Recurrence After Spacer Implantation. Traumatology and Orthopedics of Russia. 2022;28(1):7-18. (In Russian). doi: 10.17816/2311-2905-1718.
- Zimmerli W., Trampuz A., Ochsner P.E. Prosthetic joint infections. N Engl J Med. 2004;351(16):1645-1654. doi: 10.1056/NEJMra040181.
- Charette R.S., Melnic C.M. Two-Stage Revision Arthroplasty for the Treatment of Prosthetic Joint Infection. Curr Rev Musculoskelet Med. 2018;11(3):332-340. doi: 10.1007/s12178-018-9495-y.
- Lazic I., Scheele C., Pohlig F., von Eisenhart-Rothe R., Suren C. Treatment options in PJI – is two-stage still gold standard? J Orthop. 2021;23:180-184. doi: 10.1016/j.jor.2020.12.021.
- Pangaud C., Ollivier M., Argenson J.N. Outcome of single-stage versus two-stage exchange for revision knee arthroplasty for chronic periprosthetic infection. EFORT Open Rev. 2019;4(8):495-502. doi: 10.1302/2058-5241.4.190003.
- Palazzo C., Nguyen C., Lefevre-Colau M.M., Rannou F., Poiraudeau S. Risk factors and burden of osteoarthritis. Ann Phys Rehabil Med. 2016;59(3):134-138. doi: 10.1016/j.rehab.2016.01.006.
- Vina E.R., Kwoh C.K. Epidemiology of osteoarthritis: literature update. Curr Opin Rheumatol. 2018;30(2): 160-167. doi: 10.1097/BOR.0000000000000479.
- Bae K.J., Chae Y.J., Jung S.J., Gong H.S. Incidence and risk factors for periprosthetic joint infection: A common data model analysis. Jt Dis Relat Surg. 2022;33(2):303-313. doi: 10.52312/jdrs.2022.671.
- Rodriguez-Merchan E.C., Delgado-Martinez A.D. Risk Factors for Periprosthetic Joint Infection after Primary Total Knee Arthroplasty. J Clin Med. 2022;11(20):6128. doi: 10.3390/jcm11206128.
- Xu C., Wang Q., Kuo F.C., Goswami K., Tan T.L., Parvizi J. The Presence of Sinus Tract Adversely Affects the Outcome of Treatment of Periprosthetic Joint Infections. J Arthroplasty. 2019;34(6):1227-1232.e2. doi: 10.1016/j.arth.2019.02.040.
- Gabrielli A.S., Wilson A.E., Wawrose R.A., Dombrowski M., O’Malley M.J., Klatt B.A. The presence of a draining sinus is associated with failure of re-implantation during two-stage exchange arthroplasty. J Bone Jt Infect. 2022;7(2):55-60. doi: 10.5194/jbji-7-55-2022.
- Bredeche F., Gounot I., Belgaïd V., Macabeo C., Rouhana K., Aubrun F. et al. Anemia before reimplantation surgery - An overlooked modifiable risk factor of septic revision knee arthroplasty failure. SICOT J. 2020;6:47. doi: 10.1051/sicotj/2020046.
- Артюх В.А., Божкова С.А., Бояров А.А., Муравьева Ю.В., Кочиш А.А. Эффективность одноэтапного ревизионного эндопротезирования при свищевой форме хронической перипротезной инфекции тазобедренного сустава. Травматология и ортопедия России. 2021;27(2):9-22. doi: 10.21823/2311-2905-2021-27-2-9-22. Artyukh V.A., Bozhkova S.A., Boyarov A.A., Muravyova J.V., Kochish A.A. Efficiency of the One-Stage Revision Hip Arthroplasty in Chronic Periprosthetic Joint Infection with Sinus Tract. Traumatology and Orthopedics of Russia. 2021;27(2):9-22. (In Russian). doi: 10.21823/2311-2905-2021-27-2-9-22.
- Preobrazhensky P., Bozhkova S., Kochish A., Tikhilov R., Kazemirsky A. Comparative analysis of pathogen structure in patients with PJI after primary total hip and knee arthroplasty. Arch Orthop Trauma Surg. 2021;141(11):1963-1969. doi: 10.1007/s00402-021-04139-w.
- Li H., Fu J., Niu E., Chai W., Xu C., Hao L.B. et al. The risk factors of polymicrobial periprosthetic joint infection: a single-center retrospective cohort study. BMC Musculoskelet Disord. 2021;22(1):780. doi: 10.1186/s12891-021-04664-0.
- Efremov K., Benedetti Valentini M., De Maio F., Potenza V., Caterini R. et al. Periprosthetic hip and knee infections: comparison of etiology, perioperative management and costs. Eur Rev Med Pharmacol Sci. 2019;23 (2 Suppl):217-223. doi: 10.26355/eurrev_201904_17496.
- Paharik A.E., Horswill A.R. The Staphylococcal Biofilm: Adhesins, Regulation, and Host Response. Microbiol Spectr. 2016;4(2):10.1128/microbiolspec.VMBF-0022-2015. doi: 10.1128/microbiolspec.VMBF-0022-2015.
- Zmistowski B., Fedorka C.J., Sheehan E., Deirmengian G., Austin M.S., Parvizi J. Prosthetic joint infection caused by gram-negative organisms. J Arthroplasty. 2011;26 (6 Suppl):104-108. doi: 10.1016/j.arth.2011.03.044.
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