DOS Kongressen 2014 ·
57
The “true” incidence of prosthetic joint infection after
32,896 primary total hip arthroplasties: A prospective
cohort study
Per Hviid Gundtoft, Søren Overgaard, Henrik Carl Schønheyder, Jens Kjølseth
Møller, Per Kjærsgaard-Andersen, Alma Becic Pedersen
Orthopedic, Kolding Hospital and Odense University Hospital; Orthopaedic
Surgery and Traumatology, Odense University Hospital; Clinical Microbiology,
Aalborg University Hospital; Clinical Epidemiology, Aarhus University Hospital
Background:
The risk of prosthetic joint infection in patients with total hip
arthroplasty (THA) is often underestimated when based on registry data.
Purpose / Aim of Study:
The purpose of this study was to estimate the “true”
incidence of prosthetic joint infection in THA using multiple data sources.
Materials and Methods:
The Danish Hip Arthroplasty Register (DHR) was
searched for primary THAs performed between January 1, 2005 and December
31, 2011 in the Danish provinces Jutland and Funen. The DHR and the Danish
National Register of Patients (NRP) were searched to identify first revisions
following a primary THA. The revisions were classified as due to prosthetic joint
infection or to causes other than infection using an algorithm incorporating
intraoperative cultures, aspirations of joint fluid, plasma C- reactive protein,
prior use of antibiotics, and clinical findings described in the medical record. We
calculated the cumulative incidences.
Findings / Results:
A total of 32,896 primary THAs were identified. Of
these, first time revisions were reported to the DHR and/or NRP for 1,546.
The 1-year cumulative incidences of prosthetic joint infection were 0.51 % [CI
0.44; 0.59] and 0.48 % [0.41; 0.56] for the DHR and NRP, respectively; while,
the 5-year cumulative incidences were 0.64 % [0.51; 0.79] and 0.57 % [0.45;
0.71], respectively. The corresponding 1- and 5-year cumulative incidences
estimated by the algorithm were 0.86 % [0.77; 0.97] and 1.03 % [0.87; 1.22],
respectively. Thus, the “true” incidence of prosthetic joint infection in primary
THA was approximately 40 % higher compared with the national registers when
using additional data.
Conclusions:
The “true” incidence of prosthetic joint infection in primary THA
is significantly higher than reported by the Danish national registers and can be
estimated using multiple clinical and paraclinical data.
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