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Risk factors associated with revision for prosthetic joint infection following knee replacement: An observational cohort study from England and Wales

The Lancet Infectious Diseases May 27, 2019

Lenguerrand E, et al. - Researchers sought the associations between patient, surgical, and health-care system factors and risk of revision for prosthetic joint infection in this cohort study of 679 010 primary knee replacements done between 2003 and 2013 in England and Wales. A subsequent revision was done in 3659 for an indication of prosthetic joint infection, after a median follow-up of 4·6 years. A higher risk of revision for prosthetic joint infection was noted in correlation to male sex, younger age, higher American Society of Anaesthesiologists grade, elevated body-mass index, chronic pulmonary disease, diabetes, liver disease, connective tissue and rheumatic diseases, peripheral vascular disease, surgery for trauma, previous septic arthritis or inflammatory arthropathy, operation under general anaesthesia, requirement for tibial bone graft, use of posterior stabilised fixed bearing prostheses or constrained condylar prostheses. However, a lower risk of revision for prosthetic joint infection was observed in correlation wth uncemented total, patellofemoral, or unicondylar knee replacement. Depending on the time period post-surgery, most of these factors had time-specific effects.
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