Inflammatory Bowel Disease and Periprosthetic Joint Infection Following Total Joint Arthroplasty: Crohn's Disease and Ulcerative Colitis Associated With Varying Risk.

McKenzie W Culler, Matthew A Lim, Sahil S Telang, Avinash Iyer, Kevin Sun, Jay R Lieberman, Nathanael D Heckmann

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Article in Arthroplasty today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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7 authors.

McKenzie W CullerDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Matthew A LimDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Sahil S TelangDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Avinash IyerDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Kevin SunDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Jay R LiebermanDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Nathanael D HeckmannDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The risk of periprosthetic joint infection (PJI) in patients with inflammatory bowel disease (IBD) who undergo total joint arthroplasty (TJA) remains unclear as reports in the literature are inconclusive. This study sought to clarify the relationship between IBD and PJI risk after TJA. Methods: An all-payer claims database was used to identify patients who underwent primary elective TJA between 2016 and 2023. Patients who had a diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) were identified. Propensity score matching (1:7) was performed for the UC, CD, and aggregate IBD cohorts based on age, sex, and comorbidities. Ninety-day PJI risk was assessed using multivariable regression. Results: In total, 10,040 patients with IBD were identified and matched to 70,203 controls. Separately, 5474 CD patients were matched to 38,230 controls, and 4555 UC patients were matched to 31,865 controls. PJI rates were similar between the IBD and control cohorts (0.71% vs 0.61%; Discussion: CD is independently associated with increased PJI risk following TJA, while UC is not. This distinction may account for inconsistencies in the literature evaluating IBD as a risk factor for PJI.

Indexed as

Inflammatory bowel diseasePeriprosthetic joint infectionTotal hip arthroplastyTotal joint arthroplastyTotal knee arthroplasty

Identifiers

PMID42471950

DOI10.1016/j.artd.2026.102077

PMCPMC13380153

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