Evidence map›Paper›PMID 40102953›Full record

SynthesisJournal of orthopaedic surgery and research2025

Risk factors for metachronous periprosthetic joint infection in patients with multiple prosthetic joints: a systematic review and meta-analysis.

Yi Li, Xiaolin Quan, Cheng Zhou, Xin Duan, Mao Nie, Haibo Si

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. Review
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

6 authors.

Yi Li *Department of Orthopaedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, China.
Xiaolin Quan *Department of Orthopaedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.
Cheng ZhouDepartment of Orthopaedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.
Xin DuanDepartment of Orthopaedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, China.
Mao NieDepartment of Orthopaedic Surgery, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China. 302218@cqmu.edu.cn.
Haibo SiDepartment of Orthopaedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, China. sihaibo@wchscu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectAlthough periprosthetic joint infection (PJI) can affect multiple joints simultaneously, most individuals with multiple joint involvement exhibit PJI in only one joint. Data regarding the metachronous PJI management for these patients are limited. This study aimed to explore the risk factors for metachronous PJI in patients with multiple prosthetic joints, thereby guiding and optimizing clinical practice.

methodsThe MEDLINE, Web of Science, Cochrane Library, and EMBASE were searched for all clinical studies of metachronous PJI from inception until May 2024. The clinical studies on risk factors for metachronous PJI in patients with multiple prosthetic joints after experiencing a periprosthetic infection were collected, with two authors independently screening the literatures. Newcastle Ottawa scale was used as a quality assessment tool for the included studies, and the meta-analysis was conducted to evaluate the potential risk factors of metachronous PJI.

resultsA total of 1,544 patients with PJI after multiple joint arthroplasties were reported in 9 studies, including 189 with metachronous PJI. The meta-analysis showed that methicillin-resistant staphylococcus aureus (MRSA; OR, 3.43; 95%CI, 1.71-6.88; p = 0.0005), rheumatoid arthritis (RA; OR, 2.38; 95%CI, 1.06-5.38; p = 0.04), history of steroid use (OR, 2.93; 95%CI, 1.58-5.43; p = 0.0007), and previous or ongoing non-periprosthetic infection (OR, 4.47; 95%CI, 1.45-13.82; p = 0.009) were identified as significant risk factors for metachronous PJI in patients with multiple prosthetic joints. However, there was no significant difference between the metachronous PJI group and non-metachronous group in terms of revision, age, diabetes, and gender.

conclusionPatients with MRSA, RA, history of steroid use, previous or ongoing non-periprosthetic infection are at significantly higher risk for metachronous PJI. Further research is needed to optimize management strategies for preventing metachronous PJI in patients with multiple prostheses after a single joint PJI.

Indexed as

Joint ProsthesisProsthesis-Related InfectionsArthritis, RheumatoidFemaleHumansMaleMethicillin-Resistant Staphylococcus aureusRisk FactorsArthroplastyMetachronous periprosthetic joint infectionMultiple prosthetic jointsRisk factors

Identifiers

PMID40102953
PMCPMC11921538

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Registered trials

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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.