ArticleActa orthopaedica2024
Sex-based differences in risk of revision for infection after hip, knee, shoulder, and ankle arthroplasty in osteoarthritis patients: a multinational registry study of 4,800,000 implants.
Article in Acta orthopaedica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Survivorship and risk factors for revision after total hip arthroplasty in patients 30 years and younger: a cohort study from the German arthroplasty register.Acta orthopaedica · 2026Article
- Changes in systemic immune-inflammation index predict periprosthetic joint infection after hemiarthroplasty in elderly patients.Journal of bone and joint infection · 2026Article
- Association of preoperative chronic opioid use with 1-year revision rate, mortality, and patient-reported outcomes after primary hip and knee arthroplasty: age, sex and BMI matter - a Dutch register-based study.Acta orthopaedica · 2025Article
- Utilizing biomaterial surface properties to improve orthopedic hip implant safety and function in a Safe-by-Design approach.Frontiers in bioengineering and biotechnology · 2025Review
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Authors and funding
20 authors.
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Abstract
background and purposeWe aimed to determine sex differences for periprosthetic joint infections after primary arthroplasty of the hip, knee, ankle, and shoulder in osteoarthritis patients in an international perspective.
methodsThis is a multinational combined arthroplasty registry study. Each arthroplasty registry performed Cox-regression analysis of their data and reported the crude and adjusted hazard ratios (HR) with an a priori designed data form. A random-effects model was used to pool these HRs to estimate an overall HR with 95% confidence interval (CI). Adjustment was undertaken for patient age, BMI, ASA grade, type of fixation, and type of implant. 9 arthroplasty registries participated. Patients who received primary total joint arthroplasty for primary osteoarthritis were considered: 2,134,313 hip arthroplasties, 2,658,237 knee arthroplasties, 57,889 shoulder arthroplasties, and 8,445 ankle arthroplasties. We calculated hazard ratios (HR) for the overall risk of complete revision due to infection for each implant type and follow-up.
resultsThe pooled HR for revision due to infection for men compared with women at 1-year follow-up was 1.60 (95% confidence interval [CI] 1.42-1.80) for hip arthroplasties; 2.06 (CI 1.90-2.46) for knee arthroplasties; 4.51 (CI 2.99-6.80) for shoulder arthroplasties; and 0.87 (CI 0.46-1.62) for ankle arthroplasties. These results remained consistent over time and were identified in both unadjusted and adjusted models.
conclusionMen have a higher risk of revision due to infection than women after primary hip, knee, and shoulder arthroplasty. No evidence of difference was found for ankle arthroplasty. These elevated relative risks persist in the fully adjusted investigations and over the 10-year postoperative period studied.
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