ArticleJB & JS open access
High Rates of Aseptic Loosening After Revision Total Knee Arthroplasty for Periprosthetic Joint Infection.
Article in JB & JS open access. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 38 citations in OpenAlex.
- Article
- GREM1 acts in leptin receptor-expressing skeletal cells to mediate peri-implant fibrosis.Nature communications · 2026Article
- CXCL5 suppresses osteoclastogenesis and protects against lipoteichoic acid-induced bone loss by modulating PLCγ2 and c-Fos signalling in gram-positive periprosthetic joint infection.Bone & joint research · 2026Article
- Vascular remodelling and fibrotic changes in the joint capsule during periprosthetic knee infections.Bone & joint research · 2026Article
- Limb salvage in multiple revision total knee arthroplasty using customised implants: When sleeves and cones are no longer an option.Journal of experimental orthopaedics · 2026Article
- Treatment of periprosthetic joint infection - outcomes following algorithm-guided treatment at a multidisciplinary referral centre.Journal of bone and joint infection · 2026Article
- Osteoporosis exacerbates perioperative complications in total knee arthroplasty: a 10-Year nationwide analysis.Journal of orthopaedic surgery and research · 2025Article
- 'Hybrid' spacers in two-stage total hip arthroplasty revision: surgical technique, clinical and radiographic outcomes.Archives of orthopaedic and trauma surgery · 2025Article
- The role of PD-1/PD-L1 in overshooting osteoclastogenesis in periprosthetic joint infections.Communications biology · 2025Article
- Assessing the TNM Classification for Periprosthetic Joint Infections of the Knee: Predictive Validity for Functional and Subjective Outcomes.Journal of personalized medicine · 2025Article
- Prevention and treatment of peri-implant fibrosis by functionally inhibiting skeletal cells expressing the leptin receptor.Nature biomedical engineering · 2024Article
- Complications of periprosthetic fracture revision vs aseptic revision of total knee arthroplasty.Journal of orthopaedics · 2024Article
- Does antibiotic bone cement reduce infection rates in primary total knee arthroplasty?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
- Inflammatory, Oxidative Stress and Small Cellular Particle Response in HUVEC Induced by Debris from Endoprosthesis Processing.Materials (Basel, Switzerland) · 2023Article
- The role of myeloid derived suppressor cells in musculoskeletal disorders.Frontiers in immunology · 2023Review
- The Impact of Hepatitis C on Complication Rates After Revision Total Knee Arthroplasty: A Matched Cohort Study.Arthroplasty today · 2022Article
- Serum and Synovial Markers in Patients with Rheumatoid Arthritis and Periprosthetic Joint Infection.Journal of personalized medicine · 2022Article
- Candida periprosthetic joint infections - risk factors and outcome between albicans and non-albicans strains.International orthopaedics · 2022Article
- Failure Analysis in Multiple TKA Revisions-Periprosthetic Infections Remain Surgeons' Nemesis.Journal of clinical medicine · 2022Article
- Public Interest in Knee Pain and Knee Replacement during the SARS-CoV-2 Pandemic in Western Europe.Journal of clinical medicine · 2021Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
With increasing life expectancy, the demand for knee replacement is continuously rising. Despite the use of antibiotic prophylaxis and improved aseptic surgical techniques, periprosthetic joint infection (PJI) still occurs in 1% to 5% of patients after primary arthroplasty. An open question is the influence of PJI and resulting surgical procedures on the occurrence of long-term complications such as aseptic loosening. Patients needing multiple revision surgeries are especially at risk for decreases in bone mass and damage to the medullary cavity. Thus, we theorized that prior surgeries on the affected knee increase the risk of aseptic loosening in patients with PJI.
methodsWe retrospectively analyzed the cases of 100 patients who underwent total knee replacement exchange surgery as a result of PJI. In addition to clinical, paraclinical, and radiographic examination, we assessed comorbidities and the number of prior surgeries.
resultsProsthetic survival was drastically decreased after PJI-related revision arthroplasty: during the first 7.3 years after reimplantation, 22% and 16% of all patients had aseptic loosening and recurrent PJI, respectively. The prevalence of aseptic loosening was 27.8% for female and 15.2% for male patients. A significant association between increasing patients' American Society of Anesthesiologists (ASA) classification and prosthetic failure rates was found, as was a strong correlation between number of prior surgeries and aseptic loosening.
conclusionsIn this study, we found notable rates of aseptic loosening and recurrent PJI following PJI-related revision arthroplasty. The difference in the rate of aseptic loosening among male and female patients supports theories of the role of bone metabolism in the development of aseptic loosening. The economic and clinical burdens of prosthetic failure make it paramount to gain a better understanding of bone metabolism in PJI. Additional research should address the need to optimize treatment strategies to increase prosthetic survival. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Registered trials
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