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Periprosthetic Join...
Periprosthetic Joint Infection After Total Knee Arthroplasty With or Without Antibiotic Bone Cement
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- Leta, Tesfaye H. (author)
- Kaiser Permanente,Haukeland University Hospital,Weill Cornell Medical College
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- Lie, Stein Atle (author)
- University of Bergen,Haukeland University Hospital
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- Fenstad, Anne Marie (author)
- Haukeland University Hospital
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- Lygre, Stein Hakon L. (author)
- Haukeland University Hospital
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- Lindberg-Larsen, Martin (author)
- Odense University Hospital
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- Pedersen, Alma B. (author)
- Aarhus University Hospital
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- W-Dahl, Annette (author)
- Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,The Swedish Knee Arthroplasty Register
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- Rolfson, Ola, 1973 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics,Sahlgrenska Academy
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- Bülow, Erik (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics,Sahlgrenska Academy,The County of Västra Götaland
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van Steenbergen, Liza N. (author)
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- Nelissen, Rob G. H. H. (author)
- Leiden University Medical Centre,Haukeland University Hospital
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- Harries, Dylan (author)
- South Australian Health and Medical Research Institute
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de Steiger, Richard (author)
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- Lutro, Olav (author)
- Stavanger University Hospital
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- Makela, Keijo (author)
- Turku University Hospital
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- Venalainen, Mikko S. (author)
- Turku University Hospital
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Willis, Jinny (author)
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Wyatt, Michael (author)
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Frampton, Chris (author)
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Grimberg, Alexander (author)
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Steinbrueck, Arnd (author)
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Wu, Yinan (author)
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Armaroli, Cristiana (author)
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Gentilini, Maria Adalgisa (author)
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Picus, Roberto (author)
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Bonetti, Mirko (author)
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- Dragosloveanu, Serban (author)
- Carol Davila University of Medicine and Pharmacy
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Vorovenci, Andreea E. (author)
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Dragomirescu, Dan (author)
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- Dale, Havard (author)
- Haukeland University Hospital
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- Brand, Christian (author)
- University of Bern
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Christen, Bernhard (author)
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Shapiro, Joanne (author)
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- Wilkinson, J. Mark (author)
- University of Sheffield
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Armstrong, Richard (author)
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Wooster, Kate (author)
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Hallan, Geir (author)
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- Gjertsen, Jan-Erik (author)
- Haukeland University Hospital
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- Chang, Richard N. (author)
- Kaiser Permanente
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- Prentice, Heather A. (author)
- Kaiser Permanente
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- Sedrakyan, Art (author)
- Weill Cornell Medical College
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- Paxton, Elizabeth W. (author)
- Kaiser Permanente
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- Furnes, Ove (author)
- Haukeland University Hospital
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(creator_code:org_t)
- 2024
- 2024
- English.
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In: JAMA Network Open. - 2574-3805. ; 7:5
- Related links:
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http://dx.doi.org/10... (free)
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Importanc eDespite increased use of antibiotic-loaded bone cement (ALBC) in joint arthroplasty over recent decades, current evidence for prophylactic use of ALBC to reduce risk of periprosthetic joint infection (PJI) is insufficient. Objective To compare the rate of revision attributed to PJI following primary total knee arthroplasty (TKA) using ALBC vs plain bone cement. Design, Setting, and Participants This international cohort study used data from 14 national or regional joint arthroplasty registries in Australia, Denmark, Finland, Germany, Italy, New Zealand, Norway, Romania, Sweden, Switzerland, the Netherlands, the UK, and the US. The study included primary TKAs for osteoarthritis registered from January 1, 2010, to December 31, 2020, and followed-up until December 31, 2021. Data analysis was performed from April to September 2023. Exposure Primary TKA with ALBC vs plain bone cement. Main Outcomes and Measures The primary outcome was risk of 1-year revision for PJI. Using a distributed data network analysis method, data were harmonized, and a cumulative revision rate was calculated (1 - Kaplan-Meier), and Cox regression analyses were performed within the 10 registries using both cement types. A meta-analysis was then performed to combine all aggregated data and evaluate the risk of 1-year revision for PJI and all causes. Results Among 2 168 924 TKAs included, 93% were performed with ALBC. Most TKAs were performed in female patients (59.5%) and patients aged 65 to 74 years (39.9%), fully cemented (92.2%), and in the 2015 to 2020 period (62.5%). All participating registries reported a cumulative 1-year revision rate for PJI of less than 1% following primary TKA with ALBC (range, 0.21%-0.80%) and with plain bone cement (range, 0.23%-0.70%). The meta-analyses based on adjusted Cox regression for 1 917 190 TKAs showed no statistically significant difference at 1 year in risk of revision for PJI (hazard rate ratio, 1.16; 95% CI, 0.89-1.52) or for all causes (hazard rate ratio, 1.12; 95% CI, 0.89-1.40) among TKAs performed with ALBC vs plain bone cement. Conclusions and Relevance In this study, the risk of revision for PJI was similar between ALBC and plain bone cement following primary TKA. Any additional costs of ALBC and its relative value in reducing revision risk should be considered in the context of the overall health care delivery system.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Leta, Tesfaye H.
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Lie, Stein Atle
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Fenstad, Anne Ma ...
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Lygre, Stein Hak ...
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Lindberg-Larsen, ...
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Pedersen, Alma B ...
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show more...
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W-Dahl, Annette
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Rolfson, Ola, 19 ...
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Bülow, Erik
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van Steenbergen, ...
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Nelissen, Rob G. ...
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Harries, Dylan
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de Steiger, Rich ...
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Lutro, Olav
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Makela, Keijo
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Venalainen, Mikk ...
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Willis, Jinny
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Wyatt, Michael
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Frampton, Chris
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Grimberg, Alexan ...
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Steinbrueck, Arn ...
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Wu, Yinan
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Armaroli, Cristi ...
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Gentilini, Maria ...
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Picus, Roberto
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Bonetti, Mirko
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Dragosloveanu, S ...
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Vorovenci, Andre ...
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Dragomirescu, Da ...
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Dale, Havard
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Brand, Christian
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Christen, Bernha ...
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Shapiro, Joanne
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Wilkinson, J. Ma ...
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Armstrong, Richa ...
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Wooster, Kate
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Hallan, Geir
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Gjertsen, Jan-Er ...
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Chang, Richard N ...
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Prentice, Heathe ...
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Sedrakyan, Art
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Paxton, Elizabet ...
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Furnes, Ove
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Orthopaedics
- Articles in the publication
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JAMA Network Ope ...
- By the university
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University of Gothenburg
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Lund University