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Intra-Articular Injections Prior to Total Knee Arthroplasty Do Not Increase the Risk of Periprosthetic Joint Infection: A Prospective Cohort Study

Abstract : Periprosthetic joint infections (PJI) occur in 0.5 to 2.8% of total knee arthroplasties (TKA) and expose them to an increase of morbidity and mortality. TKA are mainly performed after failure of non-surgical management of knee osteoarthritis, which frequently includes intra-articular injections of corticosteroids or hyaluronic acid. Concerning the potential impact of intra-articular injections on TKA infection, literature provides a low level of evidence because of the retrospective design of the studies and their contradictory results. In this prospective cohort study, we included patients after a total knee arthroplasty, at the time of their admission in a rehabilitation center, and we excluded patients with any prior knee surgery. 304 patients were included. Mean follow-up was 24.9 months, and incidence proportion of PJI was 2.6%. After multivariate logistic regression, male was the only significant risk factor of PJI (OR = 19.6; p = 0.006). The incidence of PJI did not differ between patients who received prior intra-articular injections and others, especially regarding injections in the last 6 months before surgery. The use of intra-articular injection remains a valid therapeutic option in the management of knee osteoarthritis, and a TKA could still be discussed.
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https://www.hal.inserm.fr/inserm-03269652
Contributor : Arnaud Eyraud Connect in order to contact the contributor
Submitted on : Thursday, June 24, 2021 - 11:03:35 AM
Last modification on : Tuesday, September 28, 2021 - 4:14:06 PM
Long-term archiving on: : Saturday, September 25, 2021 - 6:18:21 PM

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Jérôme Grondin, Pierre Menu, Benoit Métayer, Vincent Crenn, Marc Dauty, et al.. Intra-Articular Injections Prior to Total Knee Arthroplasty Do Not Increase the Risk of Periprosthetic Joint Infection: A Prospective Cohort Study. Antibiotics, MDPI, 2021, 10 (3), pp.330. ⟨10.3390/antibiotics10030330⟩. ⟨inserm-03269652⟩

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