Factors Associated With 20-Year Cumulative Risk of Infection After Aseptic Index Revision Total Knee Arthroplasty

Background: The purpose of this study was to calculate the cumulative risk of periprosthetic joint infection (PJI) after aseptic index knee revisions and to identify the surgical, perioperative, and medical comorbidity risk factors associated with deep infection. Methods: We retrospectively reviewed 1802 aseptic index revision total knee arthroplasties performed at our institution from 1970 to 2000. From this cohort, there were 60 reoperations performed for deep infection. Results: The cumulative risk of infection at 1, 5, 10, and 20 years after index revision was 1%, 2.4%, 3.3%, and 5.6%, respectively. Conclusions: Male gender, use of constrained implants, increased operative times, increased Charlson Comorbidity Index, and a history of liver disease were all significantly associated with PJI. The development of cardiovascular disease, endocrine disorders, and renal disease were also associated with PJI.