{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:29:54Z","timestamp":1787617794379,"version":"build-2736575974"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2023,7,8]],"date-time":"2023-07-08T00:00:00Z","timestamp":1688774400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,8]],"date-time":"2023-07-08T00:00:00Z","timestamp":1688774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To identify clinical and laboratory predictors for low- and high-grade prosthetic joint infection (PJI) within the first postoperative days following primary total hip\/knee arthroplasty (THA\/TKA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Institutional bone and joint infection registry of a single osteoarticular infection referral centre was reviewed to identify all osteoarticular infections\u00a0treated between 2011 and 2021. Among them were 152 consecutive PJI (63 acute high-grade PJI, 57 chronic high-grade PJI, and 32 low-grade PJI) who also had primary THA\/TKA performed at the same institution, which were retrospectively analyzed with multivariate logistic regression and covariables.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>For each additional day of wound discharge, persistent wound drainage (PWD) predicted PJI in the acute high-grade PJI group with odds ratio (OR) 39.4 (<jats:italic>p<\/jats:italic> = 0.000, 95%CI 1.171\u20131.661), in the low-grade PJI group with OR 26.0 (<jats:italic>p<\/jats:italic> = 0.045, 95%CI 1.005\u20131.579), but not in the chronic high-grade PJI group (OR 16.6, <jats:italic>p<\/jats:italic> = 0.142, 95%CI 0.950\u20131.432). The leukocyte count product of pre-surgery and POD2 &gt;100 predicted PJI in the acute high-grade PJI group (OR 2.1, <jats:italic>p<\/jats:italic> = 0.025, 95%CI 1.003\u20131.039) and in the chronic high-grade PJI group (OR 2.0, <jats:italic>p<\/jats:italic> = 0.018, 95%CI 1.003\u20131.036). Similar trend was also seen in the low-grade PJI group, but was not statistically significant (OR 2.3, <jats:italic>p<\/jats:italic> = 0.061, 95%CI 0.999\u20131.048).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The most optimal threshold value for predicting PJI was observed only in the acute high-grade PJI group, where PWD &gt;three days after index surgery yielded 62.9% sensitivity and 90.6% specificity, whereby the leukocyte count product of pre-surgery and POD2 &gt;100 showed 96.9% specificity. Glucose, erythrocytes, hemoglobin, thrombocytes, and CRP showed no significant value in this regard.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00264-023-05891-x","type":"journal-article","created":{"date-parts":[[2023,7,8]],"date-time":"2023-07-08T15:02:18Z","timestamp":1688828538000},"page":"2173-2179","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical and laboratory predictors for prosthetic joint infection within the first postoperative days following primary total hip and knee arthroplasty"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9595-4840","authenticated-orcid":false,"given":"Peter","family":"Brumat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6169-1296","authenticated-orcid":false,"given":"Bla\u017e","family":"Mav\u010di\u010d","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izak","family":"Jur\u010di\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1075-3351","authenticated-orcid":false,"given":"Rihard","family":"Treb\u0161e","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,8]]},"reference":[{"key":"5891_CR1","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/j.idc.2018.06.005","volume":"32","author":"E Beam","year":"2018","unstructured":"Beam E, Osmon D (2018) Prosthetic joint infection update. Infect Dis Clin N Am 32:843\u2013859. https:\/\/doi.org\/10.1016\/j.idc.2018.06.005","journal-title":"Infect Dis Clin N Am"},{"key":"5891_CR2","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1007\/s00264-021-04958-x","volume":"45","author":"R Trebse","year":"2021","unstructured":"Trebse R, Roskar S (2021) Evaluation and interpretation of prosthetic joint infection diagnostic investigations. International Orthopaedics (SICOT) 45:847\u2013855. https:\/\/doi.org\/10.1007\/s00264-021-04958-x","journal-title":"International Orthopaedics (SICOT)"},{"key":"5891_CR3","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1111\/apm.12862","volume":"126","author":"TH Jakobsen","year":"2018","unstructured":"Jakobsen TH, Eickhardt SR, Gheorghe AG et al (2018) Implants induce a new niche for microbiomes. APMIS 126:685\u2013692. https:\/\/doi.org\/10.1111\/apm.12862","journal-title":"APMIS"},{"key":"5891_CR4","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1097\/CORR.0000000000000609","volume":"477","author":"NR Milandt","year":"2019","unstructured":"Milandt NR, Gundtoft PH, Overgaard S (2019) A single positive tissue culture increases the risk of rerevision of clinically aseptic THA: a national register study. Clin Orthop Relat Res 477:1372\u20131381. https:\/\/doi.org\/10.1097\/CORR.0000000000000609","journal-title":"Clin Orthop Relat Res"},{"key":"5891_CR5","doi-asserted-by":"publisher","first-page":"667","DOI":"10.3109\/17453674.2010.525201","volume":"81","author":"DJF Moojen","year":"2010","unstructured":"Moojen DJF, van Hellemondt G, Vogely HC et al (2010) Incidence of low-grade infection in aseptic loosening of total hip arthroplasty: a prospective multicenter study using extensive routine and broad-range 16S PCR with reverse line blot diagnostics. Acta Orthop 81:667\u2013673. https:\/\/doi.org\/10.3109\/17453674.2010.525201","journal-title":"Acta Orthop"},{"key":"5891_CR6","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.1302\/0301-620X.99B11.BJJ-2016-0655.R2","volume":"99-B","author":"AME Jacobs","year":"2017","unstructured":"Jacobs AME, B\u00e9nard M, Meis JF et al (2017) The unsuspected prosthetic joint infection. Bone Joint J 99-B:1482\u20131489. https:\/\/doi.org\/10.1302\/0301-620X.99B11.BJJ-2016-0655.R2","journal-title":"Bone Joint J"},{"key":"5891_CR7","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1016\/j.arth.2016.11.016","volume":"32","author":"K Staats","year":"2017","unstructured":"Staats K, Kolbitsch P, Sigmund IK et al (2017) Outcome of total hip and total knee revision arthroplasty with minor infection criteria: a retrospective matched-pair analysis. J Arthroplast 32:1266\u20131271. https:\/\/doi.org\/10.1016\/j.arth.2016.11.016","journal-title":"J Arthroplast"},{"key":"5891_CR8","doi-asserted-by":"publisher","first-page":"2243","DOI":"10.1007\/s00264-020-04682-y","volume":"44","author":"Q Yang","year":"2020","unstructured":"Yang Q, Wang J, Xu Y et al (2020) Incidence and risk factors of in-hospital prosthesis-related complications following total hip arthroplasty: a retrospective nationwide inpatient sample database study. Int Orthop 44:2243\u20132252. https:\/\/doi.org\/10.1007\/s00264-020-04682-y","journal-title":"Int Orthop"},{"key":"5891_CR9","doi-asserted-by":"publisher","first-page":"650","DOI":"10.3390\/jcm8050650","volume":"8","author":"CL Roman\u00f2","year":"2019","unstructured":"Roman\u00f2 CL, Khawashki HA, Benzakour T et al (2019) The W.A.I.O.T. definition of high-grade and low-grade peri-prosthetic joint infection. JCM 8:650. https:\/\/doi.org\/10.3390\/jcm8050650","journal-title":"JCM"},{"key":"5891_CR10","first-page":"85","volume":"69","author":"ME Dombrowski","year":"2020","unstructured":"Dombrowski ME, Klatt BA, Deirmengian CA et al (2020) Musculoskeletal infection society (MSIS) update on infection in arthroplasty. Instr Course Lect 69:85\u2013102","journal-title":"Instr Course Lect"},{"key":"5891_CR11","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1302\/0301-620X.103B1.BJJ-2020-1381.R1","volume":"103-B","author":"M McNally","year":"2021","unstructured":"McNally M, Sousa R, Wouthuyzen-Bakker M et al (2021) The EBJIS definition of periprosthetic joint infection: a practical guide for clinicians. Bone Joint J 103-B:18\u201325. https:\/\/doi.org\/10.1302\/0301-620X.103B1.BJJ-2020-1381.R1","journal-title":"The Bone & Joint Journal"},{"key":"5891_CR12","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1093\/cid\/cis803","volume":"56","author":"DR Osmon","year":"2013","unstructured":"Osmon DR, Berbari EF, Berendt AR et al (2013) Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the infectious diseases society of America. Clin Infect Dis 56:e1\u2013e25. https:\/\/doi.org\/10.1093\/cid\/cis803","journal-title":"Clin Infect Dis"},{"key":"5891_CR13","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1016\/j.arth.2018.02.078","volume":"33","author":"J Parvizi","year":"2018","unstructured":"Parvizi J, Tan TL, Goswami K et al (2018) The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria. J Arthroplast 33:1309\u20131314.e2. https:\/\/doi.org\/10.1016\/j.arth.2018.02.078","journal-title":"J Arthroplast"},{"key":"5891_CR14","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1016\/j.arth.2014.03.009","volume":"29","author":"J Parvizi","year":"2014","unstructured":"Parvizi J, Gehrke T (2014) International consensus group on periprosthetic joint infection. J Arthroplast 29:1331. https:\/\/doi.org\/10.1016\/j.arth.2014.03.009","journal-title":"J Arthroplast"},{"key":"5891_CR15","doi-asserted-by":"publisher","first-page":"2992","DOI":"10.1007\/s11999-011-2102-9","volume":"469","author":"J Parvizi","year":"2011","unstructured":"Parvizi J, Zmistowski B, Berbari EF et al (2011) New definition for periprosthetic joint infection: from the workgroup of the musculoskeletal infection society. Clin Orthop Relat Res 469:2992\u20132994. https:\/\/doi.org\/10.1007\/s11999-011-2102-9","journal-title":"Clin Orthop Relat Res"},{"key":"5891_CR16","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1056\/NEJMra040181","volume":"351","author":"W Zimmerli","year":"2004","unstructured":"Zimmerli W, Trampuz A, Ochsner PE (2004) Prosthetic-joint infections. N Engl J Med 351:1645\u20131654. https:\/\/doi.org\/10.1056\/NEJMra040181","journal-title":"N Engl J Med"},{"key":"5891_CR17","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/s00402-019-03304-6","volume":"140","author":"JF Blanco","year":"2020","unstructured":"Blanco JF, D\u00edaz A, Melchor FR et al (2020) Risk factors for periprosthetic joint infection after total knee arthroplasty. Arch Orthop Trauma Surg 140:239\u2013245. https:\/\/doi.org\/10.1007\/s00402-019-03304-6","journal-title":"Arch Orthop Trauma Surg"},{"key":"5891_CR18","doi-asserted-by":"publisher","first-page":"e0150866","DOI":"10.1371\/journal.pone.0150866","volume":"11","author":"SK Kunutsor","year":"2016","unstructured":"Kunutsor SK, Whitehouse MR, Blom AW et al (2016) Patient-related risk factors for periprosthetic joint infection after total joint arthroplasty: a systematic review and meta-analysis. PLoS ONE 11:e0150866. https:\/\/doi.org\/10.1371\/journal.pone.0150866","journal-title":"PLoS ONE"},{"key":"5891_CR19","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1007\/s00167-018-5231-9","volume":"29","author":"VAC Resende","year":"2021","unstructured":"Resende VAC, Neto AC, Nunes C et al (2021) Higher age, female gender, osteoarthritis and blood transfusion protect against periprosthetic joint infection in total hip or knee arthroplasties: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 29:8\u201343. https:\/\/doi.org\/10.1007\/s00167-018-5231-9","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"5891_CR20","doi-asserted-by":"publisher","first-page":"6128","DOI":"10.3390\/jcm11206128","volume":"11","author":"EC Rodriguez-Merchan","year":"2022","unstructured":"Rodriguez-Merchan EC, Delgado-Martinez AD (2022) Risk factors for periprosthetic joint infection after primary total knee arthroplasty. J Clin Med 11:6128. https:\/\/doi.org\/10.3390\/jcm11206128","journal-title":"J Clin Med"},{"key":"5891_CR21","doi-asserted-by":"publisher","first-page":"3495","DOI":"10.1007\/s00402-022-04565-4","volume":"143","author":"S Rohe","year":"2022","unstructured":"Rohe S, B\u00f6hle S, Matziolis G et al (2022) C-reactive protein during the first 6 postoperative days after total hip arthroplasty cannot predict early periprosthetic infection. Arch Orthop Trauma Surg 143:3495\u20133503. https:\/\/doi.org\/10.1007\/s00402-022-04565-4","journal-title":"Arch Orthop Trauma Surg"},{"key":"5891_CR22","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1007\/s00402-017-2709-8","volume":"137","author":"C Windisch","year":"2017","unstructured":"Windisch C, Brodt S, Roehner E, Matziolis G (2017) C-reactive protein course during the first 5 days after total knee arthroplasty cannot predict early prosthetic joint infection. Arch Orthop Trauma Surg 137:1115\u20131119. https:\/\/doi.org\/10.1007\/s00402-017-2709-8","journal-title":"Arch Orthop Trauma Surg"},{"key":"5891_CR23","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1097\/CORR.0000000000002055","volume":"480","author":"Q Lai","year":"2022","unstructured":"Lai Q, Cai K, Lin T et al (2022) Prior intra-articular corticosteroid injection within 3 months may increase the risk of deep infection in subsequent joint arthroplasty: a meta-analysis. Clin Orthop Relat Res 480:971\u2013979. https:\/\/doi.org\/10.1097\/CORR.0000000000002055","journal-title":"Clin Orthop Relat Res"},{"key":"5891_CR24","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1016\/j.arth.2020.10.003","volume":"36","author":"GJ Hong","year":"2021","unstructured":"Hong GJ, Wilson LA, Liu J, Memtsoudis SG (2021) Tranexamic acid administration is associated with a decreased odds of prosthetic joint infection following primary total hip and primary total knee arthroplasty: a national database analysis. J Arthroplast 36:1109\u20131113. https:\/\/doi.org\/10.1016\/j.arth.2020.10.003","journal-title":"J Arthroplast"},{"key":"5891_CR25","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1302\/2058-5241.6.200054","volume":"6","author":"RP Almeida","year":"2021","unstructured":"Almeida RP, Mokete L, Sikhauli N et al (2021) The draining surgical wound post total hip and knee arthroplasty: what are my options? A narrative review. EFORT Open Rev 6:872\u2013880. https:\/\/doi.org\/10.1302\/2058-5241.6.200054","journal-title":"EFORT Open Rev"},{"key":"5891_CR26","doi-asserted-by":"publisher","first-page":"3109","DOI":"10.1016\/j.arth.2018.01.025","volume":"33","author":"GR Scuderi","year":"2018","unstructured":"Scuderi GR (2018) Avoiding postoperative wound complications in total joint arthroplasty. J Arthroplast 33:3109\u20133112. https:\/\/doi.org\/10.1016\/j.arth.2018.01.025","journal-title":"J Arthroplast"},{"key":"5891_CR27","doi-asserted-by":"publisher","first-page":"S157","DOI":"10.1016\/j.arth.2018.09.066","volume":"34","author":"RK Al-Houraibi","year":"2019","unstructured":"Al-Houraibi RK, Aalirezaie A, Adib F et al (2019) General assembly, prevention, wound management: proceedings of international consensus on orthopedic infections. J Arthroplast 34:S157\u2013S168. https:\/\/doi.org\/10.1016\/j.arth.2018.09.066","journal-title":"J Arthroplast"},{"key":"5891_CR28","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/j.arth.2018.08.034","volume":"34","author":"F-CBM Wagenaar","year":"2019","unstructured":"Wagenaar F-CBM, L\u00f6wik CAM, Zahar A et al (2019) Persistent wound drainage after total joint arthroplasty: a narrative review. J Arthroplast 34:175\u2013182. https:\/\/doi.org\/10.1016\/j.arth.2018.08.034","journal-title":"J Arthroplast"},{"key":"5891_CR29","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.artd.2017.03.009","volume":"4","author":"MS Reich","year":"2017","unstructured":"Reich MS, Ezzet KA (2017) A nonsurgical protocol for management of postarthroplasty wound drainage. Arthroplasty Today 4:71\u201373. https:\/\/doi.org\/10.1016\/j.artd.2017.03.009","journal-title":"Arthroplasty Today"},{"key":"5891_CR30","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.artd.2019.05.003","volume":"5","author":"A Shahi","year":"2019","unstructured":"Shahi A, Boe R, Bullock M et al (2019) The risk factors and an evidence-based protocol for the management of persistent wound drainage after total hip and knee arthroplasty. Arthroplasty Today 5:329\u2013333. https:\/\/doi.org\/10.1016\/j.artd.2019.05.003","journal-title":"Arthroplasty Today"}],"container-title":["International Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-023-05891-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00264-023-05891-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-023-05891-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T06:03:59Z","timestamp":1692338639000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00264-023-05891-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,8]]},"references-count":30,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["5891"],"URL":"https:\/\/doi.org\/10.1007\/s00264-023-05891-x","relation":{},"ISSN":["0341-2695","1432-5195"],"issn-type":[{"value":"0341-2695","type":"print"},{"value":"1432-5195","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,8]]},"assertion":[{"value":"21 May 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the National Medical Ethics Committee of the Republic of Slovenia (0120-108\/2021\/3).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate and publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}