Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
Department of Health Sciences Research, Quantitative Health Sciences, Mayo Clinic, Rochester, MN.
J Arthroplasty. 2022 Aug;37(8S):S997-S1003.e1. doi: 10.1016/j.arth.2022.03.042. Epub 2022 Mar 17.
Extended oral antibiotic prophylaxis (EOA) has been shown to potentially reduce infection rates after high-risk primary total knee arthroplasties (TKAs) and reimplantations. However, data is limited regarding EOA after aseptic revision TKAs. This study evaluated the impact of EOA on infection-related outcomes after aseptic revision TKAs.
904 aseptic revision TKAs from 2014-2019 were retrospectively identified. Patients who received EOA >24 hours perioperatively (n = 267) were compared to those who did not (n = 637) using an inverse probability of treatment weighting model. Mean age was 66 years, mean BMI was 33 kg/m, and 54% were female. Outcomes included cumulative probabilities of any infection, periprosthetic joint infection (PJI), superficial infection, and re-revision or reoperation for infection.
The cumulative probability of any infection after aseptic revision TKA was 1.9% at 90 days, 3.5% at 1 year, and 8.1% at 5 years. Patients without EOA had a higher risk of any infection at 90 days (HR = 7.1; P = .01), but not other time points. The cumulative probability of PJI after aseptic revision TKA was 0.8% at 90 days, 2.3% at 1 year, and 6.5% at 5 years. Patients without EOA did not have an increased risk of PJI. There were no differences in re-revision or reoperation for infection at any time point between groups.
Extended oral antibiotics after aseptic revision TKA were associated with a 7-fold decreased risk of any infection at 90 days. The results suggest a potential role for EOA after aseptic revision TKA and warrant additional prospective studies.
Level III.
延长口服抗生素预防（EOA）已被证明可降低高危初次全膝关节置换术（TKA）和再植入术后的感染率。然而，关于无菌性翻修 TKA 后 EOA 的数据有限。本研究评估了 EOA 对无菌性翻修 TKA 后与感染相关结局的影响。
回顾性确定了 2014 年至 2019 年的 904 例无菌性翻修 TKA。比较了接受围手术期 24 小时以上 EOA（n=267）的患者与未接受 EOA（n=637）的患者。使用逆概率治疗加权模型进行比较。平均年龄为 66 岁，平均 BMI 为 33kg/m2，54%为女性。结果包括任何感染、假体周围关节感染（PJI）、浅表感染和因感染而再次翻修或再次手术的累积概率。
无菌性翻修 TKA 后 90 天任何感染的累积概率为 1.9%，1 年为 3.5%，5 年为 8.1%。未接受 EOA 的患者在 90 天时有更高的任何感染风险（HR=7.1；P=0.01），但在其他时间点则不然。无菌性翻修 TKA 后 PJI 的累积概率为 90 天 0.8%，1 年 2.3%，5 年 6.5%。未接受 EOA 的患者 PJI 风险并未增加。两组在任何时间点的因感染而再次翻修或再次手术均无差异。
无菌性翻修 TKA 后延长口服抗生素与 90 天任何感染风险降低 7 倍相关。结果提示 EOA 在无菌性翻修 TKA 后可能有作用，需要进一步的前瞻性研究。
III 级。
