Extended Oral Antibiotic Prophylaxis After Aseptic Revision TKA: Does It Decrease Infection Risk?

ABSTRACT

Background

Extended oral antibiotic prophylaxis (EOA) has been shown to reduce infection after high-risk primary total hip arthroplasties (THAs) and reimplantations. However, data is limited regarding EOA after aseptic revision THAs. This study evaluated the impact of EOA on infection-related outcomes after aseptic revision THAs.

Patients/Methods

We retrospectively identified 1,107 aseptic revision THAs performed between 2014 and 2019. Patients who received EOA >24 hours perioperatively (n=370) were compared to those who did not (n=737) using an inverse probability of treatment weighting model. Their mean age was 65 years (range, 19 to 98 years), mean body mass index was 30 kg/m² (range, 16 to 72), and 54% were women. Outcomes included cumulative probabilities of any infection, periprosthetic joint infection (PJI), and re-revision or reoperation for infection. Mean follow-up was 4 years (range, 2 to 8 years).

Results

The cumulative probability of any infection after aseptic revision THA was 2.3% at 90 days, 2.7% at 1 year, and 3.5% at 5 years. The cumulative probability of PJI was 1.7% at 90 days, 2.1% at 1 year, and 2.8% at 5 years. There was a trend towards increased risk of any infection (HR=2.6; p=0.058), PJI (HR=2.6; p=0.085), and re-revision (HR=6.5; p=0.077) or reoperation (HR=2.3; p=0.095) for infection in patients who did not have EOA at final clinical follow-up.

Conclusions

EOA after aseptic revision THA was not associated with a statistically significant decreased risk of any infection, PJI, or re-revision or reoperation for infection at all time points.