Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.
Department of Orthopaedic Surgery, Iran University of Medical Sciences, Tehran, Iran.
J Bone Joint Surg Am. 2020 Apr 1;102(7):543-549. doi: 10.2106/JBJS.19.00865.
Male patients undergoing total joint arthroplasty have a higher risk of periprosthetic joint infection (PJI) compared with female patients. The exact reason for this finding is not well known. This study aimed to determine if patients with symptomatic benign prostatic hyperplasia (BPH) are at increased risk of PJI.
A total of 12,902 male patients who underwent primary or revision total joint arthroplasty from January 2006 to April 2017 were retrospectively identified. The mean patient age was 62.47 years and the mean patient body mass index was 30.1 kg/m. The majority of patients were Caucasian or African American. Most surgical procedures involved the hip joints (57.8%) and were primary arthroplasties (86%). Of these patients, 386 (3%) had symptomatic BPH. Among this group, 250 patients with symptomatic BPH were identified and were matched in an approximate 1:3 ratio with 708 control patients. Using the International Consensus Meeting criteria, patients who developed PJI were identified.
The PJI rate was 7.9% in the symptomatic BPH group and 2.8% in the control group. Multivariate regression analysis in unmatched groups showed that symptomatic BPH was a strong independent risk factor for PJI. After matching for variables related to outcomes, symptomatic BPH remained a significant risk factor for PJI (p = 0.01).
Patients with symptomatic BPH had a higher risk of PJI compared with the control patients. This may partly explain the higher rate of PJI that is seen in male patients.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
与女性患者相比，接受全关节置换术的男性患者发生假体周围关节感染（PJI）的风险更高。这一发现的确切原因尚不清楚。本研究旨在确定是否患有症状性良性前列腺增生（BPH）的患者发生 PJI 的风险增加。
回顾性确定了 2006 年 1 月至 2017 年 4 月期间接受初次或翻修全关节置换术的 12902 名男性患者。患者平均年龄为 62.47 岁，平均体重指数为 30.1kg/m。大多数患者为白种人或非裔美国人。大多数手术涉及髋关节（57.8%），且为初次置换术（86%）。这些患者中，386 名（3%）患有症状性 BPH。在这一组中，确定了 250 名患有症状性 BPH 的患者，并以大约 1:3 的比例与 708 名对照患者相匹配。使用国际共识会议标准确定发生 PJI 的患者。
症状性 BPH 组的 PJI 发生率为 7.9%，对照组为 2.8%。未匹配组的多变量回归分析表明，症状性 BPH 是 PJI 的一个强有力的独立危险因素。在匹配与结局相关的变量后，症状性 BPH 仍然是 PJI 的显著危险因素（p=0.01）。
与对照组患者相比，患有症状性 BPH 的患者发生 PJI 的风险更高。这可能部分解释了男性患者 PJI 发生率较高的原因。
预后 III 级。有关证据水平的完整描述，请参阅作者指南。
