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- Title
A RETROSPECTIVE STUDY OF CLINICAL PROFILE, RISK FACTORS, MANAGEMENT AND TREATMENT OUTCOME OF PATIENTS WITH PERIPROSTHETIC JOINT INFECTIONS (PJIS) IN A TERTIARY CARE, TELANGANA, INDIA.
- Authors
Manchala, Karthik; Katukam, Avinash Kumar; Rajkamal, Guda; Bhadreshwara Anusha, Doddoju Veera
- Abstract
Introduction: Infections associated with orthopaedic implants, especially prosthetic joint infections (PJIs) are increasing with advancement in joint arthroplasty. The reported prevalence of PJI out to 2 years after hip replacement is 1.63% and after knee replacement is 1.55%. PJI for the individual patient is devastating with increased rate of mortality, increased risk of morbidity, decreased quality of life, and potential for decreased level of mobility and ambulation. Rapid detection of infection is of paramount importance because delaying the start of treatment of PJI may result in the loss of the device. The consequence of PJI is quite severe at the patient as well as the healthcare system level. Hence this study was done to understand clinical profile, risk factors, and treatment outcome which can guide clinicians in appropriate management. Methodology: A retrospective study was done in cohort of patients in a tertiary care diagnosed as periprosthetic joint infections as per guidelines by infectious disease society of America. All the patients’ records holding diagnosis as PJIs during January 2021 to December 2023 were included. After obtaining permission from institutional ethical committee clearance, data from patient’s medical records were collected and analysed. Data on patients’ socio-demographic characteristics, clinical profile, investigations, treatment modalities and outcome were retrieved. A total of 50 such patients’ records were analysed. The data were analyzed using statistical package for the social sciences (SPSS) version 20. Chi square test and students t test was used with P<0.05 considered as statistically significant. Results: Commonest symptom was joint swelling in 100%, followed by pain in joint in 86%, erythema in 84% and fever in 40%. Other symptoms were outflow around the scar and fistula in 8% and 16% respectively. PJIs were early onset, delay onset and late onset in 64%, 24% and 12% respectively. Culturally positive PJIs were 80%. On culture microbes identified were staphylococcus aureus in 44%, pseudomonas in 16%, Gram negative organisms in 16% and Enterococci in 4%. Management done with debridement, antibiotics, implant retention (DAIR), 1 stage implant exchange, 2 stage implant exchange, arthrodesis and amputation in 78%, 8%, 4%, 4% and 6% patients respectively. Function was restored in 76% and death seen in 4% of patients respectively. Conclusion: Mean haemoglobin, mean serum albumin, mean serum calcium was found to be significantly less in patients with delayed or late onset PI when compared to early onset PJI. Leucocyte count of synovial fluid and mean CRP was significantly higher in patients with delayed or late onset PJI when compared to early onset PJI.
- Subjects
PROSTHESIS-related infections; TOTAL knee replacement; ARTHROPLASTY; GRAM-negative bacteria; CHI-squared test
- Publication
Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research), 2024, Vol 15, Issue 8, p193
- ISSN
0975-3583
- Publication type
Article