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Incidence, Secular Trends, and Outcomes of Prosthetic Joint Infection: A Population-Based Study, Olmsted County, Minnesota, 1969–2007

Published online by Cambridge University Press:  02 January 2015

Geoffrey Tsaras*
Affiliation:
Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
Douglas R. Osmon
Affiliation:
Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
Tad Mabry
Affiliation:
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
Brian Lahr
Affiliation:
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
Jennifer St. Sauveur
Affiliation:
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota Rochester Epidemiology Project, Mayo Clinic, Rochester, Minnesota
Barbara Yawn
Affiliation:
Rochester Epidemiology Project, Mayo Clinic, Rochester, Minnesota Department of Medicine, Olmsted Medical Center, Rochester, Minnesota
Robert Kurland
Affiliation:
Department of Orthopedic Surgery, Olmsted Medical Center, Rochester, Minnesota
Elie F. Berbari
Affiliation:
Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota
*
Department of Medicine, University of Illinois College of Medicine, 129 Phelps Avenue #508, Rockford, IL 61108 (gtsaras@uic.edu)

Abstract

Context.

The epidemiology of prosthetic joint infection (PJI) in a population-based cohort has not been studied in the United States.

Objectives.

To provide an accurate assessment of the true incidence, secular trends, clinical manifestations, microbiology, and treatment outcomes of PJI in a population-based cohort.

Design.

Historical cohort study.

Setting.

Olmsted County, Minnesota.

Participants.

Residents who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA) between January 1, 1969, and December 31, 2007.

Methods.

Incidence rates and trends in PJI were assessed using the Kaplan-Meier method and log-rank test, as were treatment outcomes among PJI case patients.

Results.

A total of 7,375 THAs or TKAs were implanted in residents of Olmsted County during the study period. Seventy-five discrete joints in 70 individuals developed PJI, during a mean ± SD follow-up of 6.8 ± 6.1 years. The cumulative incidence of PJI was 0.5%, 0.8%, and 1.4% after 1, 5, and 10 years after arthroplasty, respectively. Overall, the rate of survival free of clinical failure after treatment of PJI was 76.8% (95% confidence interval [CI], 64.3–85.2) and 65.2% (95% CI, 33.1–76.2) at 3 and 5 years, respectively. The incidence and treatment outcomes did not significantly differ by decade of implantation, patient age at implantation, gender, or joint location.

Conclusions.

The incidence of PJI is relatively low in a population-based cohort and is a function of age of the prosthesis. Incidence trends and outcomes have not significantly changed over the past 40 years.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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