ArticleBone & joint open2025
Periprosthetic joint infection after hemiarthroplasty for hip fracture is a distinct clinical entity associated with high mortality.
Article in Bone & joint open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Microbiological Profile of Periprosthetic Infections Following Femoral Fracture: A Retrospective Analysis.Journal of clinical medicine · 2026Article
- Early Prediction of 90-Day Periprosthetic Joint Infection After Hip Arthroplasty for Proximal Femur Fracture Using Machine Learning: Development and Temporal Validation of a Predictive Model.Journal of clinical medicine · 2026Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aims: Periprosthetic joint infections (PJIs) are devastating complications. Our knowledge of hip fracture-associated hemiarthroplasty PJI (HHA-PJI) is limited compared to elective arthroplasty. The goal of this study was to describe the epidemiology, risk factors, management, and outcomes for HHA-PJI. Methods: A population-based (465,000 patients) multicentre, retrospective analysis of hip hemiarthroplasty (HHA) between January 2006 to December 2018 was conducted. PJI was defined by international consensus and treatment success as no return to operating room and survival to 90 days after the initial surgical management of the infection. Univariate, survival, and competing risk regression analyses were performed. Results: In total, 1,852 HHAs were identified (74% female; mean age 84 years (SD 7); 90-day mortality 16.7%). A total of 43 patients (2.3%) developed PJI at aged 77 years (SD 10) (56% female; 90-day-mortality 20.9%; hazard ratio (HR) 1.6; 95% CI 1.1 to 2.3; p = 0.023). The incidence of HHA-PJI was 0.77/100,000 population/year and 193/100,000 HHAs/year. The median time to PJI was 26 days (IQR 20 to 97), with 53% polymicrobial growth and 41% multidrug-resistant organisms (MDRO). Competing risk regression identified younger age (subdistribution hazard ratio (SHR) 0.86; 95% CI 0.8 to 0.92; p < 0.001), chronic kidney disease (SHR 3.41; 95% CI 1.36 to 8.56; p = 0.013), BMI > 35 kg/m Conclusion: HHA-PJI is an uncommon complication, but is significantly associated with mortality. All currently identified predictors are nonmodifiable. Due to the common polymicrobial and MDRO infections, our standard antibiotic prophylaxis may not be adequate. HHA-PJI is a different disease compared to elective PJI with distinct epidemiology, pathogens, risk factors, and outcomes, which require targeted research specific to this unique population.
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