Incidence and Management of Post-Arthroplasty Joint Infections

Abstract

Introduction: Post-arthroplasty joint infection (PJI) is a serious complication following joint replacement surgeries, associated with significant morbidity, prolonged hospitalization, and increased healthcare costs. Early diagnosis and appropriate management are crucial to optimize functional outcomes and reduce implant failure. Methods: This prospective observational study was conducted in the Department of Orthopaedics at Burdwan Medical College & Hospital over a period of one year, from May 2022 to May 2023. A total of 50 adult patients undergoing primary or revision total hip and knee arthroplasty were included. Data were collected on patient demographics (age and gender), type of arthroplasty performed, risk factors for post-arthroplasty joint infection, causative organisms, and management approaches. All patients were followed postoperatively to identify the occurrence of joint infections, and appropriate interventions were recorded. The study aimed to analyze the incidence, risk factors, microbial profile, and treatment outcomes of post-arthroplasty infections in this cohort. Results: In this study of 50 patients undergoing total hip or knee arthroplasty, the majority were aged 60 years or older (60%) and male (56%), with total knee replacement being the most common procedure (70%). Post-arthroplasty joint infections occurred in 8 patients (16%). Diabetes mellitus and prolonged surgery duration (>120 minutes) were significantly associated with infection, while obesity and revision surgery showed a non-significant trend. Staphylococcus aureus was the predominant pathogen (50%), followed by coagulase-negative staphylococci and Gram-negative organisms. Management outcomes demonstrated that two-stage revision arthroplasty achieved 100% infection control, whereas debridement with implant retention was successful in 66.7% of cases. Conclusion: Post-arthroplasty joint infections, though relatively uncommon, present significant challenges in orthopedic practice. Early recognition and timely intervention tailored to infection type and patient factors are critical to improving outcomes. Multi-disciplinary approaches combining targeted antibiotic therapy and appropriate surgical intervention remain the cornerstone of effective management.