Holy Cross Orthopedic Institute, Fort Lauderdale, Florida; Larkin Community Hospital, Department of Orthopaedic Surgery, South Miami, Florida.
Holy Cross Orthopedic Institute, Fort Lauderdale, Florida.
J Arthroplasty. 2023 May;38(5):815-819. doi: 10.1016/j.arth.2022.12.005. Epub 2022 Dec 10.
Perioperative intra-articular joint injection is a known risk factor for developing prosthetic joint infection (PJI) in the immediate preoperative and postoperative periods for total knee arthroplasty, but is less defined in unicompartmental knee arthroplasty (UKA). The goal of this study was to elucidate the risk of developing PJI after intra-articular corticosteroid injection (IACI) into a post UKA knee.
A retrospective review of a nationwide administrative claims database was performed from January 2015 to October 2020. Patients who underwent UKA and had an ipsilateral IACI were identified and matched 2:1 to a control group of primary UKA patients who did not receive IACI. Multivariate logistic analyses were conducted to assess differences in PJI rates at 6 months, 1 year, and 2 years.
A total of 47,903 cases were identified, of which 2,656 (5.5%) cases received IACI. The mean time from UKA to IACI was 355 days. The incidence of PJI in the IACI group was 2.7%, compared to 1.3% in the control group. The rate of PJI after IACI was significantly higher than the rate in the control group at 6 months, 1 year, and 2 years (all P < .05). The majority of PJI occurred within the first 6 months following IACI (75%).
In this study, IACI in a UKA doubled the risk of PJI compared to patients who did not receive an injection. Surgeons should be aware of this increased risk to aid in their decision-making about injecting into a UKA.
III, retrospective comparative study.
关节内注射在全膝关节置换术的围手术期是导致假体关节感染（PJI）的已知危险因素，尤其是在术前和术后即刻，但在单髁膝关节置换术（UKA）中则不太明确。本研究的目的是阐明 UKA 后关节内皮质类固醇注射（IACI）后发生 PJI 的风险。
对 2015 年 1 月至 2020 年 10 月期间全国性行政索赔数据库进行回顾性分析。确定接受 UKA 且同侧行 IACI 的患者，并与未行 IACI 的原发性 UKA 患者以 2:1 的比例进行匹配。采用多变量逻辑分析评估 6 个月、1 年和 2 年时 PJI 发生率的差异。
共确定 47903 例病例，其中 2656 例（5.5%）病例接受了 IACI。从 UKA 到 IACI 的平均时间为 355 天。IACI 组的 PJI 发生率为 2.7%，而对照组为 1.3%。IACI 组的 PJI 发生率在 6 个月、1 年和 2 年时均显著高于对照组（均 P<.05）。大多数 PJI 发生在 IACI 后 6 个月内（75%）。
在这项研究中，与未接受注射的患者相比，IACI 使 UKA 发生 PJI 的风险增加了一倍。外科医生应意识到这种风险增加，以便在决定是否向 UKA 注射时做出决策。
III，回顾性比较研究。
