Prevalence of Prosthetic Joint Infections in Patients With Haemophilic Arthropathy Treated at a Tertiary Hospital: A Retrospective Case-Control Study

Background Haemophilia is an X-linked inherited bleeding disorder that predisposes patients to haemophilic arthropathy (HPA), which can lead to the need for total joint arthroplasty (TJA). One of the major complications associated with TJA in this cohort is prosthetic joint infection (PJI). This study evaluated the prevalence, clinical characteristics, and microbiological profiles of PJI in haemophilic patients undergoing TJA at the Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa. Methods A retrospective comparative case-control study was performed, reviewing 208 patients (105 with HPA and 103 non-HPA controls) who underwent TJA between January 1, 2003, and December 31, 2023. Clinical, demographic, and laboratory data were collected, and PJI prevalence, common pathogens, infection-free survival, and the influence of human immunodeficiency virus (HIV) were analysed. Results The overall PJI rate was 4% in both the HPA and non-HPA groups. Staphylococcus aureus and Klebsiella pneumoniae were the most common pathogens. There was no significant difference in infection rates between the two groups. HIV status did not significantly affect the rate of PJI, and haemophilic patients had a longer infection-free survival. Conclusions Haemophilic patients undergoing TJA do not show a higher incidence of PJI compared to non-haemophilic patients. Effective clotting factor replacement therapy and infection control measures likely contribute to the reduced infection risk and longer infection-free survival.