EC Orthopaedics

The Periprosthetic Joint Infection (PJI) is one of the difficult and complex problems for a surgeon. There are many factors involved such as - Surgical and host factors. In both primary total hip and total knee replacement surgery the risk of infection is there. While surgical factors are modifiable to an extent, whereas the host factors which do pre exist is more difficult to manage. Extended oral antibiotic prophylaxis if given after primary total knee and total hip replacement surgery in patients with BMI ≥ 40 kg/m² (morbid obese) possibility of reducing the rate of early periprosthetic joint infection can be seen.

Total joint replacement surgery the risk and cost of periprosthetic joint infection (PJI) management is upon surgeons and hospitals, so many a times few centers avoid treating high-risk patients. So, the studies show that optimization of host factors is very much necessary preoperatively to decrease PJI, and also as mentioned previously the recent literature supports using extended antibiotic prophylaxis.

1. Inabathula A., et al. “Extended Oral Antibiotic Prophylaxis in High-Risk Patients Substantially Reduces Primary Total Hip and Knee Arthroplasty 90-Day Infection Rate”. Journal of Bone and Joint Surgery American24 (2018): 2103-2109.
2. Kheir MM., et al. “The AAHKS Clinical Research Award: Extended Oral Antibiotics Prevent Periprosthetic Joint Infection in High-Risk Cases: 3855 Patients With 1-Year Follow-Up”. The Journal of Arthroplasty7S (2021): S18-S25.