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May 8, 2026Arthroplasty Today0 citationsOpen Access

Timing and Trends of Periprosthetic Joint Infections Following Over 1,500,000 Primary and Revision Total Knee and Hip Arthroplasty Cases

MTMaxwell T. TrudeauNYU Langone Health EWEric WangMayo Clinic in Arizona OSOlivia SchafferNYU Langone Health

Key Points

This research aims to analyze the incidence and trends of periprosthetic joint infections following primary and revision total joint arthroplasty.
Retrospective analysis using Epic Cosmos database spanning years 2015-2023.
Identified patients through current procedural terminology codes and International Classification of Diseases codes.
Applied linear regression to analyze PJI rates.
Significant reduction in PJI rates after primary total knee arthroplasty and total hip arthroplasty over the last decade.
PJI rates remained stable for revision joint arthroplasty procedures.
Further investigation needed to understand factors behind reduced infection rates in primary procedures.

Abstract

Background: Periprosthetic joint infections (PJIs) following primary and revision total knee arthroplasty (rTKA) and revision total hip arthroplasty (rTHA) have been studied, but a contemporary large-scale analysis of incidence has not been performed. This study assessed PJI incidence and trends for TKA, THA, rTKA, and rTHA using a contemporary database. Methods: Epic Cosmos database was retrospectively queried (2015-2023). Current procedureal terminology codes identified patients: 27447 (TKA), 27130 (THA), 27486 (rTKA one component), 27487 (rTKA both components), 27134 (rTHA both components), 27137 (rTHA acetabular component), and 27138 (rTHA femoral component). PJI rates were identified using International Classification of Diseases 9/10 codes and analyzed using linear regression. Results: = .08). Conclusions: Significant PJI reduction after primary TKA and THA was observed over the last decade, but infection rates remained stable in revision cohorts. Further investigations are required to assess underlying reasons for observed PJI rate reductions following primary arthroplasty.

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