Sax Oliver C, Douglas Scott J, Pervaiz Sahir S, Salem Hytham S, Nabet Austin, Mont Michael A, Delanois Ronald E
Orthopedics. 2023 Jan-Feb;46(1):19-26. doi: 10.3928/01477447-20221003-05. Epub 2022 Oct 6.
Intra-articular injections prior to total hip arthroplasty (THA) have been associated with postoperative infections. The purpose of this study was to determine whether a temporal relationship exists between hip injections prior to THA and infection. Specifically, we asked (1) Do patients who receive hip injections within 3 months of THA have a higher incidence of prosthetic joint infections (PJIs) or surgical site infections (SSIs)? and (2) Do these patients incur higher 90-day costs? Patients with hip injections prior to THA were identified using a national database from 2010 to 2019. Three laterality-specific groups (injection 0 to 3 months, 3 to 6 months, and 6 to 12 months prior to THA)were compared with a matched cohort without prior injection (n=277,841). Primary outcomes included PJIs, SSIs, and costs. Patients who had injections within 3 months of THA had a higher incidence of PJIs at 90 days (5.1% vs 1.6%, <.01) and 1 year (6.8% vs 2.1%, <.01), when compared with the matched cohort. They also had a higher incidence of SSIs at 90 days (2.8% vs 1.2%, <.01) and 1 year (3.7% vs 1.7%, <.01). Mean costs were 13.7% higher in this injection cohort. Patients who had injections between 3 and 6 months prior to THA had higher incidence and odds of postoperative PJIs at 90 days (2.6% vs 1.6%, <.04), whereas those with injections beyond 6 months had no differences in PJIs (≥.46). Patients who receive hip injections within 3 months of undergoing primary THA are at increased risk for postoperative PJIs, SSIs, and higher costs. This study reaffirms guidelines for when to perform THAs in these populations. [. 2023;46(1):19-26.].
全髋关节置换术（THA）前进行关节内注射与术后感染有关。本研究的目的是确定THA前髋关节注射与感染之间是否存在时间关系。具体而言，我们询问：（1）在THA前3个月内接受髋关节注射的患者，其人工关节感染（PJI）或手术部位感染（SSI）的发生率是否更高？（2）这些患者的90天成本是否更高？利用2010年至2019年的国家数据库识别出THA前进行髋关节注射的患者。将三个特定侧别组（THA前0至3个月、3至6个月、6至12个月注射）与未进行过先前注射的匹配队列（n = 277,841）进行比较。主要结局包括PJI、SSI和成本。与匹配队列相比，在THA前3个月内接受注射的患者在90天时PJI的发生率更高（5.1%对1.6%，<.01），1年时也更高（6.8%对2.1%，<.01）。他们在90天时SSI的发生率也更高（2.8%对1.2%，<.01），1年时同样更高（3.7%对1.7%，<.01）。该注射队列的平均成本高出13.7%。在THA前3至6个月接受注射的患者在90天时术后PJI的发生率和几率更高（2.6%对1.6%，<.04），而在6个月后接受注射的患者在PJI方面没有差异（≥.46）。在接受初次THA前3个月内接受髋关节注射的患者术后发生PJI、SSI的风险增加，且成本更高。本研究重申了针对这些人群何时进行THA的指南。[. 2023;46(1):19 - 26.]
