Incidence and Factors Associated with Prosthetic Joint Infection Following Hip or Knee Revision Arthroplasty: A Retrospective Cohort Study.

Original Article

Abstract

Objective: To determine the incidence of prosthetic joint infection (PJI) for patients who have undergone a hip or knee revision arthroplasty within a specific period of follow-up and to establish baseline host-related factors (prior skin infection, dental disease, diabetes, obesity, smoking, age, sex, and joint type) that are associated with the development of PJI.

Methodology: This Retrospective cohort study was conducted in the Department of Orthopedic Surgery at MTI Bacha Khan Medical College and Mardan Medical Complex, Mardan by assessing the medical record.between January 2023 and August 2023. 40 patients undergoing elective revision hip or knee arthroplasty at MTI Bacha Khan Medical College and Mardan Medical Complex, Mardan, from January to August 2023. We followed patients for a mean of 532 days for PJI according to EBJIS 2021 criteria. We assessed associations using Fisher’s exact test and independent t-tests. We used a parsimonious logistic regression model to evaluate age, diabetes, and dental disease. P<0.05 was considered significant.

Results: Prior skin infection (22.5%), dental disease (32.5%), diabetes (27.5%), obesity (42.5%), and smoking (50.0%) were observed. Five patients (12.5%) developed PJI. Prior skin infection was strongly associated with PJI (55.6% vs. 0%; Fisher’s exact p<0.001; corrected OR, 77.0; 95% CI, 3.6–1640.5). Multivariable modeling was not feasible because of perfect separation.

Conclusion: Prior skin infection was strongly associated with PJI but warrants cautious interpretation because of the small sample and wide confidence interval. Age, diabetes, and dental disease were not significant. These findings support comprehensive preoperative optimization, including dermatological, metabolic, and oral health assessment.