Increased Risk of Periprosthetic Joint Infections in Patients With Hypothyroidism Undergoing Total Joint Arthroplasty

The Journal of Arthroplasty
Timothy L TanJavad Parvizi

Abstract

Although thyroxine has an important role in modulating the immune system, it has not been associated with periprosthetic joint infection. This study was conceived to examine the association between hypothyroidism and periprosthetic joint infection (PIJ). Using an institutional database, the preoperative comorbidities of 32,289 total joint arthroplasties performed between 2000 and 2013 were identified using an International Classification of Diseases, Ninth Revision-based comorbidity index. In the multivariate analysis, hypothyroidism was found to be an independent risk factor (adjusted odds ratio: 2.46; P < .0001). In addition, patients who developed PJI demonstrated higher thyroid-stimulating hormone levels than those without (P = .04). Surgeons should be aware of this increased risk of PJI in hypothyroid patients when risk stratifying, and future studies are needed to determine the potential role of thyroxine supplementation.

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Citations

Apr 14, 2020·Clinical Orthopaedics and Related Research·Arianna L GianakosMary K Mulcahey
Aug 20, 2020·Nature Reviews. Immunology·Maya SchillerAsya Rolls
Apr 3, 2019·Shoulder & Elbow·Jeremy S SomersonJerry I Huang
Nov 7, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Etienne RapackiDebbie Norring-Agerskov
Nov 21, 2020·Internal Medicine Journal·Morteza DaraeiAli Asadollahi-Amin
Jan 18, 2021·Immunology·Martin JaegerRomana T Netea-Maier
Mar 13, 2021·ANZ Journal of Surgery·Mingcheng YuanZongke Zhou
May 1, 2021·Journal of Clinical Medicine·Meletios RozisDimitrios Stergios Evangelopoulos

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