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. 2022 Sep;104-B(9):1060-1066.
doi: 10.1302/0301-620X.104B9.BJJ-2022-0116.R1.

Estimating incidence rates of periprosthetic joint infection after hip and knee arthroplasty for osteoarthritis using linked registry and administrative health data

Xingzhong Jin  1   2 , Blanca Gallego Luxan  1 , Mark Hanly  1 , Nicole L Pratt  3 , Ian Harris  4   5 , Richard de Steiger  4   6 , Stephen E Graves  3   4 , Louisa Jorm  1
Affiliations

Estimating incidence rates of periprosthetic joint infection after hip and knee arthroplasty for osteoarthritis using linked registry and administrative health data

Xingzhong Jin et al. Bone Joint J. 2022 Sep.

Abstract

Aims: The aim of this study was to estimate the 90-day periprosthetic joint infection (PJI) rates following total knee arthroplasty (TKA) and total hip arthroplasty (THA) for osteoarthritis (OA).

Methods: This was a data linkage study using the New South Wales (NSW) Admitted Patient Data Collection (APDC) and the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), which collect data from all public and private hospitals in NSW, Australia. Patients who underwent a TKA or THA for OA between 1 January 2002 and 31 December 2017 were included. The main outcome measures were 90-day incidence rates of hospital readmission for: revision arthroplasty for PJI as recorded in the AOANJRR; conservative definition of PJI, defined by T84.5, the PJI diagnosis code in the APDC; and extended definition of PJI, defined by the presence of either T84.5, or combinations of diagnosis and procedure code groups derived from recursive binary partitioning in the APDC.

Results: The mean 90-day revision rate for infection was 0.1% (0.1% to 0.2%) for TKA and 0.3% (0.1% to 0.5%) for THA. The mean 90-day PJI rates defined by T84.5 were 1.3% (1.1% to 1.7%) for TKA and 1.1% (0.8% to 1.3%) for THA. The mean 90-day PJI rates using the extended definition were 1.9% (1.5% to 2.2%) and 1.5% (1.3% to 1.7%) following TKA and THA, respectively.

Conclusion: When reporting the revision arthroplasty for infection, the AOANJRR substantially underestimates the rate of PJI at 90 days. Using combinations of infection codes and PJI-related surgical procedure codes in linked hospital administrative databases could be an alternative way to monitor PJI rates.Cite this article: Bone Joint J 2022;104-B(9):1060-1066.

Keywords: Arthroplasty; Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR); Infection; Osteoarthritis; arthroplasty registries; hip and knee arthroplasty; infections; osteoarthritis (OA); periprosthetic joint infection (PJI); revision arthroplasties; total knee and total hip arthroplasty.

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Figures

Fig. 1
Fig. 1
Annual 90-day hospital readmission rate for periprosthetic joint infection (PJI) following primary total knee arthroplasty for osteoarthritis.
Fig. 2
Fig. 2
Annual 90-day hospital readmission rate for periprosthetic joint infection (PJI) following primary total hip arthroplasty for osteoarthritis.
Fig. 3
Fig. 3
Extended definition of periprosthetic joint infection and importance score of code groups identified from binary recursive partitioning for a) total knee arthroplasty and b) total hip arthroplasty. PICC, peripherally inserted central catheter.
See this image and copyright information in PMC

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