Paper of the week: General anesthesia might be associated with early periprosthetic joint infection: an observational study of 3,909 arthroplasties. Scholten R, Leijtens B, Hannink G, Kamphuis ET, Somford MP, van Susante JLC. Acta Orthop. 2019 Jul 24:1-9. doi: 10.1080/17453674.2019.1644069.

Summary by Dr Sreeram Penna

This single institution retrospective observational study aims to identify if an association exists with choice of anesthesia and 3-month periprosthetic joint infection risk in total joint arthroplasty patients. Final cohort of 3909 patients were included in the study. It consists of 2,111 (54%) hips and 1798 (46%) Knees. Of 3909 patients 1630 (42%) received general anesthesia and 2,279 (58%) received spinal anesthesia. Researchers utilized propensity score-matched univariable logistic regression analysis to control for allocation bias. 47 early PJI discovered utilizing MSIS criteria in total cohort. Of these 28 (1.7%) occurred in general anesthesia group and 19 (0.8%) occurred in spinal anesthesia group. Statistical analysis using multivariable logistic regression model demonstrated an odds ratio for PJI of 2.0 (95% CI 1.0 – 3.7) after general anesthesia relative to the propensity score-matched patients who received spinal anesthesia.