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Journal of Clinical Infectious Diseases & Practice
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  • Research Article   
  • J Clin Infect Dis Pract 2022, Vol 7(5): 158

Risk Factors for Metachronous Vertebral Osteomyelitis after Periprosthetic Joint Infections: A Minimum Five Years Retrospective Analysis

Yu Chih Lin1,2,3, An Jhih Luo1,2, Sheng Hsun Lee2, Fu Cheng Kao1,2,3, An Shun Tai4, Yuhan Chang1,2,3, Pang Hsin Hsieh1,2,3 and Sheng Hsuan Lin4*
1Department of Orthopedic Surgery, Chang Gung Memorial Hospital (CGMH), Kweishan, Taoyuan, Taiwan
2Department of Orthopedic, Bone and Joint Research Center, Chang Gung Memorial Hospital (CGMH), Kweishan, Taoyuan, Taiwan
3Department of Orthopedic, College of Medicine, Chang Gung University (CGU), Kweishan, Taoyuan, Taiwan
4Department of Orthopedic, National Chiao Tung University, Hsinchu City, Hsinchu, Taiwan
*Corresponding Author : Sheng Hsuan Lin, Department of Orthopedic, National Chiao Tung University, Hsinchu City, Hsinchu, Taiwan, Tel: 886956598166, Email: shenglin@stat.nctu.edu.tw

Received Date: Mar 18, 2022 / Published Date: May 24, 2022

Abstract

Background: Joint arthroplasty failure is primarily caused by Periprosthetic Joint Infection (PJI). PJI treatment may result in serious complications, such as Vertebral Osteomyelitis (VO). Risk factors for the development of metachronous VO after PJI, and the outcomes of these patients, are unknown. We aimed to 1) Identify the risk factors for developing meta-chronous VO following PJI and 2) Investigate the clinical outcomes of meta-chronous VO following PJI.

Methods: We included patients with PJI who underwent surgical intervention at our institute between January 2006 and December 2020. Patients with synchronous VO following PJI were excluded from the study. Patients with meta-chronous VO after PJI were identified and monitored during a minimum follow-up period of 5 years and we analyzed their comorbidities, procedures, causative pathogens, and clinical outcomes.

Results: We identified 567 patients with PJI, of whom seven developed VO (1.2%). We identified the following risk factors for metachronous VO after PJI: Systemic Inflammatory Response Syndrome (SIRS), drug abuse, polymicrobial infection, and 3-stage resection arthroplasty or more (Odds Ratios (ORs): 1.43, 52.98, 55.83, and 29.78, respectively). All patients who developed VO had poor clinical outcomes: two out of seven patients suffered from recurrent VO and six out of seven patients suffered from recurrent PJIs.

Conclusion: Patients with PJI who have risk factors that we identified may be predisposed to metachronous VO and likely to experience poor outcomes. We suspect that bacteremia may play a role in the pathogenesis of VO following PJI, but further research is required.

Keywords: Periprosthetic joint infection; Meta-chronous vertebral osteomyelitis; Systemic inflammatory response syndrome; Staged resection arthroplasty

Citation: Lin YC, Luo AJ, Lee SH, Kao FC, Tai AS, et al. (2022) Risk Factors for Metachronous Vertebral Osteomyelitis after Periprosthetic Joint Infections: A Minimum Five-Years Retrospective Analysis. J Clin Infect Dis 7:153.

Copyright: © 2022 Lin YC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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