{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:55:31Z","timestamp":1791874531017,"version":"4.3.4"},"reference-count":57,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100001275","name":"Oak Foundation","doi-asserted-by":"publisher","award":["OCAY\u201018\u2010774\u2010OFIL"],"award-info":[{"award-number":["OCAY\u201018\u2010774\u2010OFIL"]}],"id":[{"id":"10.13039\/100001275","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF20OC0065039"],"award-info":[{"award-number":["NNF20OC0065039"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004046","name":"Karen Elise Jensens Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004046","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare the 2\u2010year incidence of (1) revision due to periprosthetic joint infection (PJI) and (2) all\u2010cause revision after primary knee arthroplasty (KA) in patients with\/without obesity and to compare the microbial profiles in early (\u2264\u200990 days) and late (91\u2013730 days) PJI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A nationwide, register\u2010based cohort of patients undergoing primary total or unicompartmental KA for osteoarthritis in Denmark (2011\u20132023). Patients were stratified by body mass index (BMI), with obesity defined as BMI\u2009\u2265\u200930\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Cox proportional hazards models estimated hazard ratios (HRs) with corresponding two\u2010sided 95% confidence intervals (95% CIs) for PJI and all\u2010cause revision within 2 years. Analyses included crude and propensity score\u2010adjusted models based on health and socioeconomic data. Microbial profiles were compared using absolute risk difference (ARD) with 95% CIs in the early and late post\u2010operative periods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 111,117 eligible patients, 41,306 had obesity (mean BMI: 34.6) and 59,993 did not (mean BMI: 26.1). Patients with obesity were slightly younger and had higher use of glucose\u2010lowering medication. Patients with obesity had a higher risk of PJI revision than those without obesity (482 [1.2%] vs. 559 [0.9%]; crude HR: 1.25 [1.11\u20131.42], and propensity\u2010adjusted HR: 1.30, 95% CI: 1.14\u20131.48). The adjusted risk of all\u2010cause revision was comparable (1494 [3.6%] vs. 1893 [3.2%]; HR: 1.05, 95% CI: 0.98\u20131.13). Within 90 days, patients with obesity had more polymicrobial infections (62 [18.5%] vs. 43 [11.3%]; ARD: 7.2%, 95% CI: 2.0%\u201312.5%) and more non\u2010staphylococcal gram\u2010positive organisms (69 [21%] vs. 54 [14%]; ARD: 6.3%, 95% CI: 0.8%\u201312%).\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      was the most frequent pathogen in both groups (127 [38%] vs. 136 [36%]; ARD: 2.0%, 95% CI: \u22125.1% to 9.1%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Obesity was associated with an increased 2\u2010year risk of PJI after KA; however, the risk of all\u2010cause revision was comparable to that in patients without obesity. Within 90 days, patients with obesity exhibited a higher incidence of polymicrobial infections and non\u2010staphylococcal gram\u2010positive organisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II, prognostic studies\u2014investigating natural history and evaluating the effect of a patient characteristic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70513","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:39:23Z","timestamp":1782848363000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patients with obesity have a higher risk of periprosthetic joint infection and more frequent polymicrobial infections after knee arthroplasty: A nationwide register\u2010based study from Denmark"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8784-995X","authenticated-orcid":false,"given":"Saber M.","family":"Aljuboori","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology Copenhagen University Hospital, Bispebjerg and Frederiksberg Copenhagen Denmark"},{"name":"Section for Biostatistics and Evidence\u2010Based Research the Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3777-147X","authenticated-orcid":false,"given":"Espen","family":"Jimenez\u2010Solem","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"},{"name":"Copenhagen Phase IV Unit (Phase4CPH), Department of Clinical Pharmacology and Center of Clinical Research and Prevention at Copenhagen University Hospital Bispebjerg and Frederiksberg Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Calum","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Hvidovre Hospital Copenhagen University Hospital Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6600-0631","authenticated-orcid":false,"given":"Robin","family":"Christensen","sequence":"additional","affiliation":[{"name":"Section for Biostatistics and Evidence\u2010Based Research the Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg Copenhagen Denmark"},{"name":"Research Unit of Rheumatology, Department of Clinical Research Odense University Hospital University of Southern Denmark Odense 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