As the population ages and demand for total joint arthroplasty increases, rates of periprosthetic joint infection (PJI) are expected to increase in the geriatric population. Studies comparing prevalence of risk factors, etiology, management, and mortality of prosthetic joint infection in older patients are lacking.
We compared clinical characteristics, management, and mortality of patients <75 vs ≥ 75 years of age with first prosthetic joint infection of the hip or knee admitted to a tertiary medical center between September 2017 and December 2019.
Ninety-eight patients (<75 years of age (n=63); ≥75 years of age (n=35) were studied.
Groups were similar in terms of etiology, culture directed therapy, antibiotic suppression, and length of stay. There was no difference in surgical management, performed in almost 97% of cases in both groups. Arrhythmia and heart failure were more prevalent in those ≥75. Readmission related to prosthetic joint infection occurred less often in older individuals (p=0.005). Deaths within one year of diagnosis were rare (n=4; 4.1%), occurring in older patients and resulting mostly from sepsis.
In our single-center study, patients with first prosthetic joint infection had similar management, regardless of age. We identified cardiac history as one of the host factors for prosthetic joint infection most seen in patients ≥75. Though deaths were rare, one-year mortality was higher in patients ≥75. Prospective, multi-center studies are needed to explore risk factors and management strategies of prosthetic joint infection among in elderly populations.
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