2025 ISAKOS Biennial Congress ePoster
Evaluating The Temporal Relationship And Risk Factors For Pji Following Erysipelas In Arthroplasty Patients
Taner Karlidag, MD GERMANY
David Luo, MD, PhD, Hamburg GERMANY
Jochen Salber, MD, PhD, Bochum, Deutschland GERMANY
Mustafa Citak, MD, Prof., MBA, Hamburg GERMANY
Helios ENDO Klinik Hamburg, Hamburg, GERMANY
FDA Status Not Applicable
Summary
The purpose of this study was to: 1) Is there a correlation between the onset of erysipelas, combined with certain patient-related risk factors, and the occurrence of periprosthetic joint infection?, 2) Does this correlation exhibit variations based on the localization of erysipelas? and, 3) Is there a correspondence between specific risk factors and the time interval from erysipelas to PJI?
ePosters will be available shortly before Congress
Abstract
Background
Erysipelas, a superficial form of cellulitis, predominantly affects the lower limbs, involving an acute, superficial infection of the upper dermis. After hip and knee arthroplasty surgeries, erysipelas can often mimic periprosthetic joint infection (PJI). The purpose of this study was to investigate the association between erysipelas and development of PJI.
Methods
This was a retrospective review of medical records from May 2016 to June 2021 at a tertiary referral center. A total of 289 patients who had developed erysipelas following hip or knee arthroplasty were included in the study. The current study has also conducted a medical condition-specific analysis regarding the time interval between the onset of erysipelas and the development of PJI.
Results
Separate logistic regression analyses found that rheumatoid arthritis (RA) significantly increased the risk of (PJI) following erysipelas, with an odds ratio (OR) of 8.24 (95% CI: 3.15 to 21.56). Each previous surgery on the joint increased PJI odds by 1.33 times (95% CI: 1.08 to 1.63). In hip arthroplasty patients, RA had an OR of 43.74 (95% CI: 3.99 to 480.16) for PJI, with previous surgeries and heart failure (HF) also raising PJI odds. In knee arthroplasty patients, RA increased PJI risk OR:10.34 (95% CI: 2.70 to 39.57). Additionally, patients with RA developed PJI sooner (mean 16.6 days) than those with HF (mean 64.2 days) or without RA/HF (mean 220.3 days) (p<0.001).
Conclusion
Patients undergoing total hip arthroplasty and total knee arthroplasty with factors such as RA, HF, or a history of multiple surgeries are at an increased risk of PJI following erysipelas. Therefore, it is imperative to provide close perioperative monitoring for this vulnerable patient population. The initial three weeks following erysipelas, patients with RA and three months those with HF face a heightened risk of PJI, necessitating thorough monitoring and follow-up care.