Evidence map›Paper›PMID 40092417›Full record

ArticleArthroplasty today2025

Angiotensin-Converting Enzyme Inhibition as a Potential Risk Factor for Periprosthetic Joint Infection Following Total Knee Arthroplasty.

Rishi Trikha, Nicolas Cevallos, Alan L Zhang, Sanjiv M Narayan, Christos Photopoulos, Alexandra Stavrakis, Nicholas M Bernthal

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Arthroplasty today, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rishi TrikhaDepartment of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA, USA.
Nicolas CevallosDepartment of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA.
Alan L ZhangDepartment of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA.
Sanjiv M NarayanDepartment of Medicine, Stanford University Cardiovascular Institute, Stanford, CA, USA.
Christos PhotopoulosDepartment of Orthopaedic Surgery, Cedars Sinai Kerlan-Jobe Institute, Los Angeles, CA, USA.
Alexandra StavrakisDepartment of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA, USA.
Nicholas M BernthalDepartment of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) portends significant morbidity. Methods: A retrospective review of the Mariner PearlDiver database was performed. Patients were divided into those taking either an ACEi or an ARB for 1 year prior to primary TKA. Irrigation and debridement and/or removal of knee prostheses procedural codes were used to identify PJI. Odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed with significance defined as a Results: After propensity score matching, 39,103 patients were included in each group. The ACEi group had a higher rate of PJI compared to the ARB group at 6 months (OR: 2.69; 95% CI: 1.43-5.09; Conclusions: Perioperative use of ACEi was associated with a substantially higher rate of PJI than use of ARBs. Further studies are warranted to elucidate if this represents immunosuppression or other mechanisms related to ACEi. Regardless, given the relative clinical interchangeability of ACEis and ARBs, ACEi treatment may represent an underappreciated, modifiable perioperative infectious risk factor.

Indexed as

Angiotensin-converting enzyme inhibitorsAngiotensin receptor blockersPeriprosthetic joint infectionTotal knee arthroplasty

Identifiers

PMID40092417
PMCPMC11909446

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.