Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2008 Dec 15;59(12):1713-20.
doi: 10.1002/art.24060.

Incidence and risk factors of prosthetic joint infection after total hip or knee replacement in patients with rheumatoid arthritis

Tim Bongartz  1 , Christine S Halligan, Douglas R Osmon, Megan S Reinalda, William R Bamlet, Cynthia S Crowson, Arlen D Hanssen, Eric L Matteson
Affiliations
Comparative Study

Incidence and risk factors of prosthetic joint infection after total hip or knee replacement in patients with rheumatoid arthritis

Tim Bongartz et al. Arthritis Rheum. .

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow of patients into the rheumatoid arthritis (RA) cohort. SpA = spondylarthritis; SLE = systemic lupus erythematosus; GCA = giant cell arteritis; ACR = American College of Rheumatology.
See this image and copyright information in PMC

References

    1. Darouiche RO. Treatment of infections associated with surgical implants. N Engl J Med. 2004;350:1422–9. - PubMed
    1. Ahlberg A, Carlsson AS, Lindberg L. Hematogenous infection in total joint replacement. Clin Orthop Relat Res. 1978;137:69–75. - PubMed
    1. Powers KA, Terpenning MS, Voice RA, Kauffman CA. Prosthetic joint infections in the elderly. Am J Med. 1990;88:9N–13N. - PubMed
    1. Doran MF, Crowson CS, Pond GR, O’Fallon WM, Gabriel SE. Frequency of infection in patients with rheumatoid arthritis compared with controls: a population-based study. Arthritis Rheum. 2002;46:2287–93. - PubMed
    1. Bernatsky S, Hudson M, Suissa S. Anti-rheumatic drug use and risk of serious infections in rheumatoid arthritis. Rheumatology (Oxford) 2007;46:1157–60. - PubMed

Publication types

Substances