Prevalence, microbiological features, and risk factors for periprosthetic joint infections in oncologic patients following tumor resection and megaprosthetic reconstruction

Abstract

Periprosthetic joint infection (PJI) after tumor resection and megaprosthetic reconstruction of bone defects is a common complication. The purpose of this study was to evaluate the prevalence of these infections, assess their microbiological profile, and identify perioperative risk factors for these complications. A single-center retrospective cohort study was conducted including 273 patients, who had undergone musculoskeletal tumor resection and megaprosthetic reconstruction. The medical records of these patients were screened for several parameters, including development of postoperative PJI. All reviewed parameters were compared between patients who developed infections and those who did not. Infection developed in 36 patients, indicating an incidence of 13.2 % (95 % confidence interval (CI): 9.4 %–17.8 %). The most common isolated pathogens in patients with PJI included coagulase-negative staphylococci (n=20; 56 %), followed by Staphylococcus aureus (n=9; 25 %). Multivariable logistic regression analysis indicated that development of PJI was associated with diabetes (odds ratio (OR): 7.64; 95 % confidence interval (CI): 1.36–42.7; p=0.020), a lower albumin level (OR: 0.10; 95 % CI: 0.02–0.49; p=0.005), and a prolonged duration of surgery (OR: 4.30; 95 % CI: 1.08–17.1; p=0.038). Our results indicate that certain parameters such as diabetes, low albumin levels, and prolonged duration of surgery are associated with a higher risk of infection.</p