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Tsaras, Geoffrey; Osmon, Douglas R.; Mabry, Tad; Lahr, Brian; Sauveur, Jennifer St.; Yawn, Barbara; Kurland, Robert; Berbari, Elie F.

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

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  • Media type: E-Article
  • Title: Incidence, Secular Trends, and Outcomes of Prosthetic Joint Infection: A Population-Based Study, Olmsted County, Minnesota, 1969–2007
  • Contributor: Tsaras, Geoffrey; Osmon, Douglas R.; Mabry, Tad; Lahr, Brian; Sauveur, Jennifer St.; Yawn, Barbara; Kurland, Robert; Berbari, Elie F.
  • imprint: Cambridge University Press (CUP), 2012
  • Published in: Infection Control & Hospital Epidemiology
  • Language: English
  • DOI: 10.1086/668421
  • ISSN: 0899-823X; 1559-6834
  • Origination:
  • Footnote:
  • Description: <jats:sec id="S0195941700050529_abs1"><jats:title>Context.</jats:title><jats:p>The epidemiology of prosthetic joint infection (PJI) in a population-based cohort has not been studied in the United States.</jats:p></jats:sec><jats:sec id="S0195941700050529_abs2"><jats:title>Objectives.</jats:title><jats:p>To provide an accurate assessment of the true incidence, secular trends, clinical manifestations, microbiology, and treatment outcomes of PJI in a population-based cohort.</jats:p></jats:sec><jats:sec id="S0195941700050529_abs3"><jats:title>Design.</jats:title><jats:p>Historical cohort study.</jats:p></jats:sec><jats:sec id="S0195941700050529_abs4"><jats:title>Setting.</jats:title><jats:p>Olmsted County, Minnesota.</jats:p></jats:sec><jats:sec id="S0195941700050529_abs5"><jats:title>Participants.</jats:title><jats:p>Residents who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA) between January 1, 1969, and December 31, 2007.</jats:p></jats:sec><jats:sec id="S0195941700050529_abs6"><jats:title>Methods.</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec id="S0195941700050529_abs7"><jats:title>Results.</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec id="S0195941700050529_abs8"><jats:title>Conclusions.</jats:title><jats:p>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.</jats:p></jats:sec>