Journal article
Do Extended Oral Postoperative Antibiotics Prevent Early Periprosthetic Joint Infection in Morbidly Obese Patients Undergoing Primary Total Joint Arthroplasty?
The Journal of arthroplasty, Vol.36(8), pp.2716-2721
08/01/2021
DOI: 10.1016/j.arth.2021.03.018
PMID: 33781639
Abstract
Background: Extended oral antibiotic prophylaxis after primary total knee arthroplasty (TICS) and total hip arthroplasty (THA) in patients with body mass index (BMI) >= 40 kg/m(2) may reduce the rate of early periprosthetic joint infection (PJI); however, existing data are limited. The purpose of this study was to examine rates of wound complications and PJI in patients with BMI >= 40 kg/m(2) treated with and without extended oral antibiotic prophylaxis after surgery.
Methods: We retrospectively identified all primary THA and TICS performed since 2015 in patients with a BMI >= 40 kg/m(2) at a single institution. Extended oral antibiotic prophylaxis for 7-14 days after surgery was prescribed at the discretion of each surgeon. Wound complications and PJI were examined at 90 days postoperatively.
Results: In total, 650 cases (205 THA and 445 TICS) were analyzed. Mean age was 58 years and 62% were women. Mean BMI was 44 kg/m(2). Extended oral antibiotic prophylaxis was prescribed in 177 cases (27%). At 90 days, there was no difference between prophylaxis and nonprophylaxis groups in rate of wound complications (11% vs 8%; P = .41) or PJI (1.7% vs 0.6%; P = .35). The univariate analysis demonstrated increased operative time (odds ratio (OR) 1.01; 95% confidence interval (95% CI) 1.01-1.02) and diabetes mellitus (OR 1.88; 95% CI 1.03-3.46) to be associated with increased risk of 90-day wound complications. No patient factors were associated with increased risk of PJI at 90 days postoperatively.
Conclusion: Extended oral antibiotic prophylaxis after primary THA and TICS did not reduce rates of wound complications or early PJI in a morbidly obese patient population. (C) 2021 Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Do Extended Oral Postoperative Antibiotics Prevent Early Periprosthetic Joint Infection in Morbidly Obese Patients Undergoing Primary Total Joint Arthroplasty?
- Creators
- Christopher N. Carender - University of IowaDavid E. DeMik - University of IowaNatalie A. Glass - University of IowaNicolas O. Noiseux - University of Iowa Hospitals and ClinicsTimothy S. Brown - University of IowaNicholas A. Bedard - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.36(8), pp.2716-2721
- Publisher
- Elsevier
- DOI
- 10.1016/j.arth.2021.03.018
- PMID
- 33781639
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Number of pages
- 6
- Language
- English
- Date published
- 08/01/2021
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984303987702771
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