Effects of Urinary Tract Infection on Hip and Knee Arthroplasty Outcomes

Introduction: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common procedures performed in the United States. However, the effects of periprosthetic joint infections (PJI) can be devastating leading to invasive interventions and potentially impaired functionality, decreased patient satisfaction, and increased mortality. Many risk factors for the development of PJIs have been well-documented, however, the association between urinary tract infections (UTIs) and PJIs remains controversial. Our aim was to establish the risk of developing a PJI in patients with an identified UTI in the preoperative, perioperative, and postoperative periods. Methods: Through retrospective chart review, data was abstracted from electronic medical records from JPS Health Network of all patients with a scheduled THA and TKA since 2014. We identified patients with UTIs 15 days prior to surgery and followed up with 12 months post-surgery for development of PJI. Results: A total of 2,220 surgeries were scheduled, and 1,697 surgeries were completed. Forty-six patients with a UTI completed surgery within 15 days of the UTI diagnosis, and 2 patients developed a PJI (4.3%, 95% Confidence limits: 0.5%, 14.8%) within 12 months post-surgery. Out of 1,274 patients with surgery without UTI, 47 (3.7%, 95% confidence limit: 2.7%, 4.9%) developed a PJI. Conclusions: Our data does not suggest UTI in the preoperative period increases the risk of PJIs after THA and TKA. However, the study needs more power to establish significant results and future analysis will look at the association between UTIs in postoperative settings and development of PJI.