1. Socioeconomic Disadvantage Predicts Decreased Likelihood of Maintaining a Functional Knee Arthroplasty Following Treatment for Prosthetic Joint Infection.
- Author
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Pagani NR, Grant A, Bamford M, Peterman N, Smith EL, and Gordon MR
- Subjects
- Humans, Male, Female, Retrospective Studies, Aged, Middle Aged, Socioeconomic Factors, Knee Joint surgery, Aged, 80 and over, United States, Socioeconomic Disparities in Health, Arthroplasty, Replacement, Knee, Prosthesis-Related Infections surgery, Reoperation statistics & numerical data, Knee Prosthesis adverse effects
- Abstract
Background: Prosthetic joint infection (PJI) carries major morbidity and mortality as well as a complicated and lengthy treatment course. In patients who have high degrees of socioeconomic disadvantage, this may be a particularly devastating complication. Our study sought to evaluate the impact of socioeconomic deprivation on outcomes following treatment for PJI of the knee., Methods: We conducted a retrospective review of revision total knee arthroplasty (TKA) procedures performed for the treatment of initial PJI between 2008 and 2020 at a single tertiary care center in the United States. The Area Deprivation Index (ADI) was used to quantify socioeconomic deprivation. The primary outcome measure was presence of a functional knee joint at the time of most recent follow-up defined as TKA components or an articulating spacer. A total of 96 patients were included for analysis. The median follow-up duration was 26.5 months., Results: There was no significant difference in the rate of treatment failure (P = .63). However, the proportion of patients who had a functional knee arthroplasty (in contrast to having undergone arthrodesis, amputation, or retention of a static spacer) declined significantly with increasing ADI index (81.8% for the least disadvantaged group, 58.7% for the middle group, 42.9% for the most disadvantaged group, P = .021)., Conclusions: Patients who have a higher socioeconomic disadvantage as measured by ADI are less likely to maintain a functional knee arthroplasty following treatment for TKA PJI. These findings support continued efforts to improve access to care and optimize treatment plans for patients who have socioeconomic disadvantage., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
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