A retrieval analysis perspective on revision for infection

Michael A. Kokko, Matthew Abdel, Daniel J. Berry, Rebecca D. Butler, Douglas W. Van Citters

Research output: Contribution to journalArticle

Abstract

Background: Retrieval analysis has long served the orthopaedic community as a tool for understanding implant failure modes; however, what retrieval studies can reveal about the nature of prosthetic joint infection (PJI) remains unknown. We hypothesize that records from a comprehensive joint retrieval program should corroborate clinically-reported temporal characteristics of prosthesis-related infection. Methods: We examined 2527 records documenting a decade of explanted hip and knee components to quantify the following: (1) the relative contribution of infection to revision arthroplasty; (2) the effects of joint type, revision status, and reason for retrieval on indwelling time; and (3) whether the temporal distribution of infected explants reflects clinical experience. Results: In this series, 20% (507/2527) of explants were performed for infection, with PJI being more commonly implicated in the retrieval of revision implants than of primaries. Infected prostheses were explanted 23.2 months sooner on average than those retrieved for other causes. Within the subset of infected devices, revision components were explanted 11.2 months sooner than primaries, with no appreciable difference observed between hips and knees. Retrieval-based temporal distributions were most similar to PJI studies with endpoint enrollment or long duration follow-up, suggesting a later average onset of infection than reported in comparable clinical studies with short (<10-year) follow-up. Conclusions: Infection represents a major cause of revision arthroplasty, and is associated with shorter indwelling times in revision components than in primaries. Studies with less than 10 years of follow-up are likely to under-report late PJI.

Original languageEnglish (US)
Pages (from-to)362-370
Number of pages9
JournalArthroplasty Today
Volume5
Issue number3
DOIs
StatePublished - Sep 1 2019

Fingerprint

Infection
Joints
Prosthesis-Related Infections
Arthroplasty
Hip
Knee
Reoperation
Prostheses and Implants
Orthopedics
Equipment and Supplies

Keywords

  • Epidemiology
  • Orthopaedic retrieval analysis
  • Prosthesis-related infections
  • Prosthetic joint infection
  • Statistics

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Kokko, M. A., Abdel, M., Berry, D. J., Butler, R. D., & Van Citters, D. W. (2019). A retrieval analysis perspective on revision for infection. Arthroplasty Today, 5(3), 362-370. https://doi.org/10.1016/j.artd.2019.03.007

A retrieval analysis perspective on revision for infection. / Kokko, Michael A.; Abdel, Matthew; Berry, Daniel J.; Butler, Rebecca D.; Van Citters, Douglas W.

In: Arthroplasty Today, Vol. 5, No. 3, 01.09.2019, p. 362-370.

Research output: Contribution to journalArticle

Kokko, MA, Abdel, M, Berry, DJ, Butler, RD & Van Citters, DW 2019, 'A retrieval analysis perspective on revision for infection', Arthroplasty Today, vol. 5, no. 3, pp. 362-370. https://doi.org/10.1016/j.artd.2019.03.007
Kokko, Michael A. ; Abdel, Matthew ; Berry, Daniel J. ; Butler, Rebecca D. ; Van Citters, Douglas W. / A retrieval analysis perspective on revision for infection. In: Arthroplasty Today. 2019 ; Vol. 5, No. 3. pp. 362-370.
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