Periprosthetic Joint Infection Is Associated with an Increas
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Researchers assessed the 90-day risk of Venous Thromboembolism (VTE) following revision total knee replacement to measure the association between periprosthetic joint infection and the risk of postoperative VTE.

All New York State residents undergoing revision total knee replacement were identified. ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes were used to identify comorbidities and to classify the indication for revision total knee replacement as aseptic, infection, or fracture.

The primary outcome was any diagnosis code for VTE recorded for the revision surgery and/or subsequent admissions within 90 days. A multivariable logistic regression model that included demographic characteristics and comorbidities was used to estimate the risk of VTE after revision for infection or fracture, with aseptic revision as the reference group.

Results:
--The present study included 25,441 patients who were managed with revision total knee replacement; the indication for revision was aseptic for 17,563 patients, infection for 7,075 , and fracture for 803.

--The mean age (and standard deviation) was 66 ± 12 years, 15,592 of the patients were female, 3,198 were Black, 1,192 were smokers, and 4,222 were obese.

--719 patients had VTE within the 90 days after revision total knee replacement, including 387 during the admission for the revision procedure.

--The 90-day incidence of VTE was 2.1% after aseptic revision, 4.3% after revision for infection, and 5.9% after revision for fracture.

--The adjusted odds ratio (aOR) for VTE relative to aseptic revision was 2.01 for septic revision total knee replacement and 2.62 for fracture.

--A history of VTE was also a strong risk factor for VTE following revision total knee replacement (aOR, 2.01).

Finally, it was discovered that the risk of VTE after revision total knee replacement for infection was double that of revision total knee replacement for aseptic reasons. Despite the fact that fractures account for a small percentage of revision overall knee replacements, the risk of VTE was 2.6 times higher. When deciding on postoperative VTE prophylaxis, the indication for revision complete knee replacement should be considered.

Source: https://www.jbjs.org/reader.php?id=207824&rsuite_id=2817341&native=1&topics=kn&source=The_Journal_of_Bone_and_Joint_Surgery/Publish+Ahead+of+Print//10.2106/JBJS.20.01486/abstract#info
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