A multicentric analysis of delayed and late prosthetic joint infections following total knee replacement: A 5-year retrospective study
Ravikumar Mukartihal, Nanda Kumar, Vimal Nair, Sreedhish Nambiar, Sharan S. Patil, Soujanya WilsonAbstract
Background:
Prosthetic joint infection (PJI) after total knee replacement (TKR) is a serious complication, with limited Indian data on delayed and late PJI. This study evaluated the incidence, microbiological characteristics, comorbidity profile, and outcomes of delayed and late PJI following TKR.
Materials and Methods:
A multicentric retrospective study was conducted at four tertiary arthroplasty centers in India (January 2010–June 2015; follow-up till June 2017). Among 15,000 primary TKRs, PJI was identified as per Musculoskeletal Infection Society criteria. Delayed PJI was defined as infection at 3–24 months postsurgery; late PJI as beyond 24 months. Demographic, comorbidity, microbiological, and outcome data were analyzed descriptively.
Results:
Of 201 PJI cases, 27 (13.4%) were delayed/late, giving an incidence of 0.18%. The cohort had 12 males and 15 females (mean age: 64 years), with 12 delayed and 15 late infections. Gram-negative organisms accounted for 6 cases (22.2%), mainly
Conclusion:
Delayed/late PJI incidence was 0.18%. Diabetes and obesity were frequently observed among patients with delayed and late PJI; however, causal associations could not be established in the absence of a control group, with Gram-negative organisms more frequent than in Western data. High culture-negativity reflects diagnostic challenges, supporting the need for risk-factor optimization and long-term surveillance.