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The Epidemiology of Total Joint Arthroplasty Infections
Book chapter

The Epidemiology of Total Joint Arthroplasty Infections

David J. Jaekel, Kevin L. Ong, Edmund C. Lau and Steven M. Kurtz
Infected Total Joint Arthroplasty, pp 35-54
29 Oct 2012
DOI: https://doi.org/10.1007/978-1-4471-2482-5_6

Abstract

Elbow Hip Incidence Knee Projections Shoulder
Prosthetic joint infection (PJI) is a rare occurrence following joint arthroplasty, which has a significant impact on the patient population. This chapter critically reviews the literature to form a consensus on the epidemiology of PJI within total joint arthroplasty. PJI occurs in 0.7–1.1 % of total knee (TKA) and hip arthroplasty (THA) cases in the USA and internationally but is projected to grow to 6.5–6.8 % by 2030. The infection rate for TKA is higher than for THA and is performed almost twice as much. Infection is diagnosed within the first year for 60 % of primary surgeries, and the vast majority of cases occur within 2 years. Among reasons for revision, infection is projected to become the most frequent and is currently around 25 % of revisions for TKA and 15 % for THA. Infection is also more prevalent after previous revision for infection and can occur in 10–33 % of those cases. The largest risk factors for concern were found to be gender, BMI > 50, extended length procedures, lack of antibiotic bone cement, and comorbidities. Other arthroplasty procedures such as total disk replacement and total shoulder arthroplasty have similar infection rates to TKA that range from 1.3 to 3.8 %. In contrast though, total elbow arthroplasty can have infection rates as high as 12 %, which may be a result of the subcutaneous nature of the elbow joint and its surrounding thin soft tissue envelope.

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7 citations in Scopus

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