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Background and Purpose:  Prosthetic joint infection (PJI) following total hip arthroplasty (THA) has a severe impact on patients. We investigated the risk of second revision and mortality following first-time revision due to PJI., Methods:  We identified 1,669 first-time revisions including 416 treated with debridement, antibiotics, and implant retention (DAIR) from the Danish Hip Arthroplasty Register (DHR). First-time revision due to PJI was defined as a revision with ≥ 2 culture-positive biopsies for the same bacteria or re-ported as PJI to the DHR within 1 year after primary THA with non-PJI revisions as controls. We retrieved information on Charlson Comorbidity Index (CCI), death, cohabitation status, and cultures from intraoperative biopsies. The adjusted relative risk (RR) with 95% confidence interval (CI) was calculated by first-time revision (PJI or non-PJI). Patients were followed from first-time revision until end of study., Results:  PJI was found in 140 of 280 patients having a second revision following any first-time revision. Of these 280 patients, 200 were treated with DAIR as second revision. Patients with first-time revision due to PJI had an increased risk of second revision compared with first-time revision for non-PJI with an adjusted RR for second revision due to any cause of 2.7 (CI 1.9-3.8) and second revision due to PJI of 6.3 (CI 4.0-10). The 10-year adjusted RR for mortality for patients with first-time revision due to PJI compared with non-PJI was 1.8 (CI 0.7-4.5)., Conclusion:  The risk of second revision was increased both for second revision due to any reason and due to PJI following first-time revision due to PJI. Mortality risk following first-time revision due to PJI was increased, but not statistically significant.

Background: Prosthetic joint infection (PJI) following total hip arthroplasty (THA) is a complication associated with increased risk of death. There is limited knowledge about the association between infection before THA, and risk of revision due to PJI. We investigated the association between any previous hospital-diagnosed or community-treated infection 0 to 6 months before primary THA and the risk of revision., Methods: We obtained data on 58,449 patients who were operated with primary unilateral THA between 2010 and 2018 from the Danish Hip Arthroplasty Register. Information on previous infection diagnoses, redeemed antibiotic prescriptions up to 1 year before primary THA, intraoperative biopsies, and cohabitations was retrieved from Danish health registers. All patients had a 1-year follow-up. Primary outcome was revision due to PJI. Secondary outcome was any revision. We calculated the adjusted relative risk with 95% confidence intervals (CI), treating death as competing risk., Results: Among 1,507 revisions identified, 536 were due to PJI with a cumulative incidence of 1.0% ([CI] 0.9 to 1.2) and 0.9% ([CI] 0.8 to 1.0) for patients who did and did not have previous infection. For any revision, the cumulative incidence was 3.1% ([CI] 2.9 to 3.4) and 2.4% ([CI] 2.3 to 2.6) for patients who did and did not have previous infection. The adjusted relative risk for PJI revision was 1.1 ([CI] 0.9 to 1.4) and for any revision 1.3 ([CI] 1.1 to 1.4) for patients who did have previous infection compared to those who did not., Conclusion: Previous hospital-diagnosed or community-treated infection 0 to 6 months before primary THA does not increase the risk of PJI revision. It may be associated with increased risk of any revision., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Aims : Danish surveillance data indicated a higher risk of revision due to prosthetic joint infection (PJI) following total hip arthroplasty (THA) performed during the summer season. We investigated the association between summer and revision risk following primary THA. Methods : This study identified 58 449 patients from the Danish Hip Arthroplasty Register (DHR) with unilateral primary THA due to osteoarthritis from 2010-2018. From Danish Health Registries, we retrieved information on Charlson Comorbidity Index (CCI), immigration, and death and microbiological data on intraoperative biopsies and cohabitation status. Meteorological data were received from the Danish Meteorological Institute. Summer was defined as June-September, and THAs performed during October-May were used as controls. The primary outcome was revision due to PJI: the composite of revision with ≥ 2 culture-positive biopsies or reported PJI to the DHR. The secondary outcome was any revision. The cumulative incidences of revision and the corresponding adjusted relative risk (RR) with 95 % confidence intervals (CI) were calculated by season of the primary THA. Results : A total of 1507 patients were revised, and 536 were due to PJI. The cumulative incidence for THAs performed during summer and the rest of the year was 1.1 % (CI 1.0-1.3) and 1.1 % (CI 1.0-1.2) for PJI revision and 2.7 % (CI 2.5-3.0) and 2.5 % (CI 2.4-2.7) for any revision, respectively. The adjusted RR for THAs performed during summer vs. the rest of the year for PJI revision and any revision was 1.1 (CI 0.9-1.3) and 1.1 (CI 1.0-1.2), respectively. Conclusion : We found no association between summer and the risk of PJI revision or any revision in a northern European climate., Competing Interests: The contact author has declared that none of the authors has any competing interests., (Copyright: © 2024 Rajzan Joanroy et al.)

Introduction: Ankle fractures treated with open reduction and internal fixation (ORIF) have a high incidence of wound complications. By reducing oedema, wound complications can, in theory, be minimized. This study investigates the impact of compression stocking (CS) on such complications after treatment with ORIF., Methods: Compression stockings were introduced as a standard postoperative treatment for all ankle fracture patients treated operatively with ORIF on February 1, 2013. Data were retrieved from medical records two years prior to and following the introduction date. The primary outcome was wound healing status after six weeks and secondary outcomes were wound-healing and major complications up to one year after surgery., Results: In total, 187 patients were studied, 74 in the CS group and 113 in the control (non-CS) group. Six weeks after the operation, wound-healing problems occurred in 23% and 13% of the patients in the CS group and the non-CS group (p < 0.0001) respectively. In total, 34% and 19% of the patients in the CS group and non-CS group experienced wound-healing complications one year after the operation (p < 0.02) respectively. Furthermore, major complications within one year occurred in 3% and 4% of patients respectively (p < 0.77)., Conclusion: An increase in wound-healing complications after six weeks and one year when using CS was found. However, owing to baseline differences in the two groups, it is only possible to caution against the use of CS., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)