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. 2012 Dec;33(12):1207-12.
doi: 10.1086/668421. Epub 2012 Oct 23.

Incidence, secular trends, and outcomes of prosthetic joint infection: a population-based study, olmsted county, Minnesota, 1969-2007

Geoffrey Tsaras  1 , Douglas R Osmon, Tad Mabry, Brian Lahr, Jennifer St Sauveur, Barbara Yawn, Robert Kurland, Elie F Berbari
Affiliations

Incidence, secular trends, and outcomes of prosthetic joint infection: a population-based study, olmsted county, Minnesota, 1969-2007

Geoffrey Tsaras et al. Infect Control Hosp Epidemiol. 2012 Dec.

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 [Formula: see text] 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.

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Conflict of interest statement

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. No relevant Conflict of interest of any of the authors.

Figures

Figure 1
Figure 1. Kaplan Meir Plot of Overall Survival of Total Hip or Knee Arthroplasty free of Prosthetic Joint Infection for Residents of Olmsted County, 1969–2007*
*Number of Total Joints = 7367
Figure 2
Figure 2
Figure 2a, above: Kaplan Meir Plot of Overall Outcome Free of Treatment Failure for All Patients with Prosthetic Joint Infection. N= 75. Figure 2b, above: Kaplan Meir Plot of Outcome Free of Treatment Failure for Patients with Prosthetic Joint Infection by Type of Initial Surgical Strategy. N= 75.
Figure 2
Figure 2
Figure 2a, above: Kaplan Meir Plot of Overall Outcome Free of Treatment Failure for All Patients with Prosthetic Joint Infection. N= 75. Figure 2b, above: Kaplan Meir Plot of Outcome Free of Treatment Failure for Patients with Prosthetic Joint Infection by Type of Initial Surgical Strategy. N= 75.
See this image and copyright information in PMC

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