title: Mortality following revision total knee arthroplasty: a matched cohort study of septic versus aseptic revisions.
abstract: We report the medium-term mortality after septic versus aseptic revision total knee arthroplasty (TKA) and factors that can contribute to mortality in revision TKA. Mortality rates of 88 patients undergoing septic revision (septic group) were compared with age- and year of surgery-matched 88 patients of aseptic revision (aseptic group). The overall mortality after revision TKA was 10.7% at a median of 4 years of follow-up (range, 2-7 years). However, the mortality after septic revision (18%, 16/88) was six times higher than that of aseptic revision (3%, 3/88) (P = 0.003). Infections with Staphylococcus aureus and/or methicillin resistance was not associated with higher mortality rates. Multivariate analysis indicated that increased age (P < 0.001), higher ASA class (P = 0.002), and septic revision (P < 0.001) were identified as independent predictors of increased mortality after revision TKA.
authors.affiliation: The Harris Orthopedic Laboratory and Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Ho-Rim
authors.initials: HR
authors.lastname: Choi
authors.affiliation: The Harris Orthopedic Laboratory and Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Hany
authors.initials: H
authors.lastname: Bedair
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000401:mortality*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure / Q000209:etiology; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000382:microbiology / Q000401:mortality*; D012086:Reoperation / Q000401:mortality*; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: aseptic revision; longer-term; mortality; septic revision; total knee arthroplasty