The Effect of Prosthetic Joint Infection on Work Status and Quality of Life: A Multicenter, International Study

J Arthroplasty. 2023 Dec;38(12):2685-2690.e1. doi: 10.1016/j.arth.2023.06.015. Epub 2023 Jun 22.

Abstract

Background: Periprosthetic joint infection (PJI) and subsequent revision surgeries may affect patients' social and physical health, ability to complete daily activities, and disability status. This study sought to determine how PJI affects patients' quality of life through patient-reported outcome measures with minimum 1-year follow-up.

Methods: Patients who suffered PJI following primary total joint arthroplasty (TJA) from 2012 to 2021 were retrospectively reviewed. Patients met Musculoskeletal Infection Society criteria for acute or chronic PJI, underwent revision TJA surgery, and had at least 1 year of follow-up. Patients were surveyed regarding how PJI affected their work and disability status, as well as their mental and physical health. Outcome measures were compared between acute and chronic PJIs. In total, 318 patients (48.4% total knee arthroplasty and 51.6% total hip arthroplasty) met inclusion criteria.

Results: Following surgical treatment for knee and hip PJI, a substantial proportion of patients reported that they were unable to negotiate stairs (20.5%), had worse physical health (39.6%), and suffered worse mental health (25.2%). A high proportion of patients reported worse quality of life (38.5%) and social satisfaction (35.3%) following PJI. Worse reported patient-reported outcome measures including patients' ability to complete daily physical activities were found among patients undergoing treatment for chronic PJI, and also, 23% of patients regretted their initial decision to pursue primary TJA.

Conclusions: A PJI negatively affects patients' ability to carry out everyday activities. This patient population is prone to report challenges overcoming disability and returning to work. Patients should be adequately educated regarding the risk of PJI to decrease later potential regrets.

Level of evidence: Case series (IV).

Keywords: PROMs; activities of daily living; periprosthetic joint infection; quality of life; total joint arthroplasty.

Publication types

  • Multicenter Study

MeSH terms

  • Arthritis, Infectious* / etiology
  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Humans
  • Prosthesis-Related Infections* / epidemiology
  • Prosthesis-Related Infections* / etiology
  • Quality of Life
  • Retrospective Studies