Paper of the week. Mortality During Total Hip Periprosthetic Joint Infection. Natsuhara KM, Shelton TJ, Meehan JP, Lum ZC. J Arthroplasty. 2018 Dec 24. pii: S0883-5403(18)31225-7. doi: 10.1016/j.arth.2018.12.024.

Summary and Editorial by Sreeram Penna

This publication is a systemic review of the literature and its main aim is to identify the mortality rate following two-stage procedure for total hip periprosthetic joint infection (PJI). The review included 23 studies on 19169 patients. Average weighted age of the patients was 65 years and average follow up was 3.7 years. Researchers showed that average overall mortality after total hip PJI was 5.4% and mortality per year increased 4.22% year after year following total hip PJI. This data translates to around 21.12% five-year mortality for total hip PJI. This pooled data result is similar to big studies included in this review. [1,2] Among the issues highlighted by researchers include underreported mortality and inadequate follow up in the studies included in the systemic review. Researchers also noticed no change in trends of mortality rate over time. Although some studies show that a substantial decline in PJI mortality rate without changes in PJI risk over time.[3] Overall this research highlights fact that PJI has considerable mortality and morbidity and considerable research needed to be done in this respect.

References

[1] Zmistowski B, Karam JA, Durinka JB, Casper DS, Parvizi J. Periprosthetic Joint Infection Increases the Risk of One-Year Mortality. The Journal of Bone and Joint Surgery-American Volume 2013;95:2177–2184. doi:10.2106/JBJS.L.00789.

[2] Cancienne JM, Werner BC, Bolarinwa SA, Browne JA. Removal of an Infected Total Hip Arthroplasty: Risk Factors for Repeat Debridement, Long-term Spacer Retention, and Mortality. J Arthroplasty 2017;32:2519–22. doi:10.1016/j.arth.2017.03.018.

[3] Kurtz SM, Lau EC, Son M-S, Chang ET, Zimmerli W, Parvizi J. Are We Winning or Losing the Battle With Periprosthetic Joint Infection: Trends in Periprosthetic Joint Infection and Mortality Risk for the Medicare Population. J Arthroplasty 2018;33:3238–45. doi:10.1016/j.arth.2018.05.042.