Total Hip or Knee Arthroplasty in Patients with a History of Native Joint Septic Arthritis: A Meta-analysis and Systematic Review of Risk Factors of Prosthetic Joint Infection

Background: Septic arthritis is a debilitating diagnosis, and many of these patients elect to undergo total knee arthroplasty (TKA) and total hip arthroplasty (THA). The purpose of this systematic review and meta-analysis is to assess the risk of prosthetic joint infection (PJI) in those who undergo primary TKA or THA with a history of septic joint arthritis. Secondarily, we will evaluate patient-specific or surgical factors that could increase the risk of primary arthroplasty failure. Methods: A comprehensive search of PubMed, CINAHL Plus, Embase, and Scopus was performed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for study selection, data extraction, and analysis. From a total of 404 articles, 18 studies were selected for inclusion. Conclusions: Male sex and resistant organism as causes of septic arthritis were associated with an increased risk of PJI in patients with a history of native septic arthritis. Single- and 2-stage procedures had similar success rates. Future studies should be larger and focus on long-term outcomes in these patients.