Hyaluronic acid injections administered within two months prior to total knee arthroplasty increase the risk for periprosthetic joint infection

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2024-12-20 DOI:10.1016/j.knee.2024.12.003

Conor M. Jones, Alexander J. Acuña, Enrico M. Forlenza, John D.D. Higgins, Tad Gerlinger, Craig J. Della Valle

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引用次数: 0

Abstract

Background

It remains unknown how timing of preoperative intra-articular knee hyaluronic acid (HA) injections impacts risk for developing postoperative periprosthetic joint infection (PJI) following total knee arthroplasty (TKA).

Methods

The PearlDiver Mariner database was utilized to identified patients undergoing primary TKA between 2015 and 2022 who received an HA injection without a corticosteroid injection within 12 months prior to surgery. The HA cohort was matched 1:1 to a control cohort undergoing no preoperative injections (corticosteroid or HA). Multivariable logistic regression analysis was utilized to determine the risk of preoperative HA injections on PJI at 1, 3, 6, 12, and 24 months postoperative. The following pre-operative intervals between injection and TKA were evaluated: 0–1 month, 1–2 months, 2–3 months, 4–6 months, and 7–12 months.

Results

38,546 patients (HA: n = 19,273; Control: n = 19,273) were analyzed. HA injections within 1 month prior to surgery demonstrated significant increase in rates of PJI at 3-months (OR: 3.00, 95% CI: 1.29 – 6.47; p = 0.005), 6-months (OR: 2.66, 95% CI: 1.30 – 5.46; p = 0.007), 12-months (OR: 2.37, 95% CI: 1.20 – 4.67; p = 0.013), and 24-months (OR: 2.65, 95% CI: 1.50 – 4.68; p < 0.001) postoperatively. HA injections between 1–2 months prior to surgery showed increased rates of PJI at 12-months (OR: 1.60, 95% CI: 1.06–2.41; p = 0.011) postoperatively. No difference in infection risk was demonstrated between patients receiving injections > 2 months prior to surgery relative to matched controls.

Conclusions

Intra-articular hyaluronic acid injections administered within 2 months of TKA appear to increase the risk of PJI.

查看原文本刊更多论文

全膝关节置换术前两个月内注射透明质酸会增加假体周围关节感染的风险。

背景：目前尚不清楚术前关节内注射透明质酸（HA）的时机如何影响全膝关节置换术（TKA）术后假体周围关节感染（PJI）的风险。方法：利用PearlDiver Mariner数据库识别2015年至2022年间接受原发性TKA的患者，这些患者在手术前12个月内接受了HA注射而没有皮质类固醇注射。血凝素组与未进行术前注射（皮质类固醇或血凝素）的对照组按1:1匹配。采用多变量logistic回归分析确定术后1、3、6、12和24个月术前注射HA对PJI的风险。评估注射与TKA的术前间隔：0-1个月、1-2个月、2-3个月、4-6个月、7-12个月。结果：38,546例患者(HA: n = 19,273；对照组：n = 19273)。术前1个月内注射HA显示3个月时PJI发生率显著增加(OR: 3.00, 95% CI: 1.29 - 6.47；p = 0.005),持续(或:2.66,95%置信区间CI: 1.30 - 5.46;p = 0.007), 12个月(或:2.37,95%置信区间CI: 1.20 - 4.67;p = 0.013)和24个月(OR: 2.65, 95% CI: 1.50 - 4.68；P术前2个月相对于对照组。结论：TKA术后2个月内关节内注射透明质酸似乎会增加PJI的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.