CORR Insights®: What Are the Long-term Outcomes of Mortality, Quality of Life, and Hip Function after Prosthetic Joint Infection of the Hip? A 10-year Follow-up from Sweden

Periprosthetic joint infection (PJI) remains one of the most common and devastating complications of total joint arthroplasty. PJI causes serious morbidity, revision surgery, and a high risk of death. The economic burden of PJI is substantial, with a projected cost to the healthcare system of USD 1.6 billion per year [²].

While we have reasonable estimates about the economic impact and mortality rates associated with PJI, we know very little about the long-term functional outcomes following its treatment. Studying patients with PJI is challenging because they often are lost to follow-up or do not want to participate in research, perhaps because of the poor results they have experienced. Furthermore, some are medically fragile and cannot travel.

The current study [⁴] was able to overcome many of these problems by investigating this information through the Swedish Hip Arthroplasty Registry. The study reported a high risk of death among patients who experienced PJI of the hip: 45% at 10 years [⁴]. They also noted that these patients experienced decreased quality of life over a sustained period of time, including impaired mobility, compared to the non-PJI cohort. In addition, the authors examined other risk factors that were associated with decreased functional outcomes, and found the direct lateral approach, gender (women), and three or more operations were associated with lower Oxford Hip Scores. While many of these findings have been reported previously at short- and mid-term follow-up, it is rare to see such a high follow-up rate of a large sample size at 10 years.