Sex-based differences in risk of revision for infection after hip, knee, shoulder, and ankle arthroplasty in osteoarthritis patients: a multinational registry study of 4,800,000 implants
Background and purpose: We aimed to determine sex differences for periprosthetic joint infections after primary arthroplasty of the hip, knee, ankle, and shoulder in osteoarthritis patients in an international perspective. Methods: This is a multinational combined arthroplasty registry study. Each...
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Medical Journals Sweden
2024-12-01
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| Series: | Acta Orthopaedica |
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| Online Access: | https://actaorthop.org/actao/article/view/42183 |
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| author | Anne M C Roerink Rob G H H Nelissen Carl Holder Stephen E Graves Michael Dunbar Eric Bohm Alexander W Grimberg Arnd Steinbrück Håvard Dale Anne Marie Fenstad Ashley W Blom Erik Lenguerrand Christopher Frampton Tine Willems Jan Victor Mireia Espallargues Jorge Arias-de la torre Enrico Ciminello Marina Torre Bart G Pijls |
| author_facet | Anne M C Roerink Rob G H H Nelissen Carl Holder Stephen E Graves Michael Dunbar Eric Bohm Alexander W Grimberg Arnd Steinbrück Håvard Dale Anne Marie Fenstad Ashley W Blom Erik Lenguerrand Christopher Frampton Tine Willems Jan Victor Mireia Espallargues Jorge Arias-de la torre Enrico Ciminello Marina Torre Bart G Pijls |
| author_sort | Anne M C Roerink |
| collection | DOAJ |
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Background and purpose: We aimed to determine sex differences for periprosthetic joint infections after primary arthroplasty of the hip, knee, ankle, and shoulder in osteoarthritis patients in an international perspective.
Methods: This is a multinational combined arthroplasty registry study. Each arthroplasty registry performed Cox-regression analysis of their data and reported the crude and adjusted hazard ratios (HR) with an a priori designed data form. A random-effects model was used to pool these HRs to estimate an overall HR with 95% confidence interval (CI). Adjustment was undertaken for patient age, BMI, ASA grade, type of fixation, and type of implant. 9 arthroplasty registries participated. Patients who received primary total joint arthroplasty for primary osteoarthritis were considered: 2,134,313 hip arthroplasties, 2,658,237 knee arthroplasties, 57,889 shoulder arthroplasties, and 8,445 ankle arthroplasties. We calculated hazard ratios (HR) for the overall risk of complete revision due to infection for each implant type and follow-up.
Results: The pooled HR for revision due to infection for men compared with women at 1-year follow-up was 1.60 (95% confidence interval [CI] 1.42–1.80) for hip arthroplasties; 2.06 (CI 1.90–2.46) for knee arthroplasties; 4.51 (CI 2.99–6.80) for shoulder arthroplasties; and 0.87 (CI 0.46–1.62) for ankle arthroplasties. These results remained consistent over time and were identified in both unadjusted and adjusted models.
Conclusion: Men have a higher risk of revision due to infection than women after primary hip, knee, and shoulder arthroplasty. No evidence of difference was found for ankle arthroplasty. These elevated relative risks persist in the fully adjusted investigations and over the 10-year postoperative period studied.
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| format | Article |
| id | doaj-art-13b8d67a00f6408692a80e32584edea2 |
| institution | Kabale University |
| issn | 1745-3674 1745-3682 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj-art-13b8d67a00f6408692a80e32584edea22024-12-10T15:40:15ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822024-12-019510.2340/17453674.2024.42183Sex-based differences in risk of revision for infection after hip, knee, shoulder, and ankle arthroplasty in osteoarthritis patients: a multinational registry study of 4,800,000 implantsAnne M C Roerink0https://orcid.org/0000-0001-8384-4935Rob G H H Nelissen1https://orcid.org/0000-0003-1228-4162Carl Holder2Stephen E Graves3Michael Dunbar4https://orcid.org/0000-0003-3629-498XEric Bohm5Alexander W Grimberg6https://orcid.org/0000-0001-8062-788XArnd Steinbrück7Håvard Dale8Anne Marie Fenstad9https://orcid.org/0000-0002-6429-0153Ashley W Blom10Erik Lenguerrand11Christopher Frampton12Tine Willems13Jan Victor14Mireia Espallargues15Jorge Arias-de la torre16Enrico Ciminello17Marina Torre18https://orcid.org/0000-0003-3851-187XBart G Pijls19https://orcid.org/0000-0001-5351-5057Department of Orthopaedics, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Orthopaedics, Leiden University Medical Center, Leiden, The NetherlandsSouth Australian Health and Medical Research Institute (SAHMRI), Adelaide, AustraliaAustralian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide; Clinical and Health Sciences, University of South Australia, Adelaide, AustraliaDivision of Orthopaedics, Dalhousie University, Halifax, Nova Scotia; Canadian Joint Replacement Registry, CanadaCanadian Joint Replacement Registry; Concordia Joint Replacement Group, University of Manitoba, Winnipeg, CanadaGerman Arthroplasty Registry (EPRD Deutsche Endoprothesenregister gGmbH), Berlin, GermanyGerman Arthroplasty Registry (EPRD Deutsche Endoprothesenregister gGmbH), Berlin, GermanyThe Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen; Department of Clinical Medicine, University of Bergen, Bergen, NorwayThe Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, NorwayBristol Medical School, University of Bristol, Bristol, UKBristol Medical School, University of Bristol, Bristol, UKDepartment of Medicine, University of Otago, Christchurch, New ZealandDepartment of Rehabilitation Sciences, Ghent University, Ghent, BelgiumDepartment of Orthopedics and Traumatology; Ghent University, Ghent University Hospital, Ghent, Belgiumgència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, SpainAgència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain; 17 Care in Long Term Conditions Research Division, King’s College London, London, UK; CIBER Epidemiology and Public Health (CIBERESP), Madrid; Institute of Biomedicine (IBIOMED). Universidad de León, León, SpainItalian Arthroplasty Registry (RIAP), Rome; Italian National Institute of Health, Rome, ItalyItalian Arthroplasty Registry (RIAP), Rome; Italian National Institute of Health, Rome, ItalyDepartment of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands Background and purpose: We aimed to determine sex differences for periprosthetic joint infections after primary arthroplasty of the hip, knee, ankle, and shoulder in osteoarthritis patients in an international perspective. Methods: This is a multinational combined arthroplasty registry study. Each arthroplasty registry performed Cox-regression analysis of their data and reported the crude and adjusted hazard ratios (HR) with an a priori designed data form. A random-effects model was used to pool these HRs to estimate an overall HR with 95% confidence interval (CI). Adjustment was undertaken for patient age, BMI, ASA grade, type of fixation, and type of implant. 9 arthroplasty registries participated. Patients who received primary total joint arthroplasty for primary osteoarthritis were considered: 2,134,313 hip arthroplasties, 2,658,237 knee arthroplasties, 57,889 shoulder arthroplasties, and 8,445 ankle arthroplasties. We calculated hazard ratios (HR) for the overall risk of complete revision due to infection for each implant type and follow-up. Results: The pooled HR for revision due to infection for men compared with women at 1-year follow-up was 1.60 (95% confidence interval [CI] 1.42–1.80) for hip arthroplasties; 2.06 (CI 1.90–2.46) for knee arthroplasties; 4.51 (CI 2.99–6.80) for shoulder arthroplasties; and 0.87 (CI 0.46–1.62) for ankle arthroplasties. These results remained consistent over time and were identified in both unadjusted and adjusted models. Conclusion: Men have a higher risk of revision due to infection than women after primary hip, knee, and shoulder arthroplasty. No evidence of difference was found for ankle arthroplasty. These elevated relative risks persist in the fully adjusted investigations and over the 10-year postoperative period studied. https://actaorthop.org/actao/article/view/42183ArthroplastyFoot and ankleHipInfectionJoint registriesKnee |
| spellingShingle | Anne M C Roerink Rob G H H Nelissen Carl Holder Stephen E Graves Michael Dunbar Eric Bohm Alexander W Grimberg Arnd Steinbrück Håvard Dale Anne Marie Fenstad Ashley W Blom Erik Lenguerrand Christopher Frampton Tine Willems Jan Victor Mireia Espallargues Jorge Arias-de la torre Enrico Ciminello Marina Torre Bart G Pijls Sex-based differences in risk of revision for infection after hip, knee, shoulder, and ankle arthroplasty in osteoarthritis patients: a multinational registry study of 4,800,000 implants Acta Orthopaedica Arthroplasty Foot and ankle Hip Infection Joint registries Knee |
| title | Sex-based differences in risk of revision for infection after hip, knee, shoulder, and ankle arthroplasty in osteoarthritis patients: a multinational registry study of 4,800,000 implants |
| title_full | Sex-based differences in risk of revision for infection after hip, knee, shoulder, and ankle arthroplasty in osteoarthritis patients: a multinational registry study of 4,800,000 implants |
| title_fullStr | Sex-based differences in risk of revision for infection after hip, knee, shoulder, and ankle arthroplasty in osteoarthritis patients: a multinational registry study of 4,800,000 implants |
| title_full_unstemmed | Sex-based differences in risk of revision for infection after hip, knee, shoulder, and ankle arthroplasty in osteoarthritis patients: a multinational registry study of 4,800,000 implants |
| title_short | Sex-based differences in risk of revision for infection after hip, knee, shoulder, and ankle arthroplasty in osteoarthritis patients: a multinational registry study of 4,800,000 implants |
| title_sort | sex based differences in risk of revision for infection after hip knee shoulder and ankle arthroplasty in osteoarthritis patients a multinational registry study of 4 800 000 implants |
| topic | Arthroplasty Foot and ankle Hip Infection Joint registries Knee |
| url | https://actaorthop.org/actao/article/view/42183 |
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