{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:28:27Z","timestamp":1787790507270,"version":"build-2784847793"},"reference-count":47,"publisher":"Elsevier BV","issue":"9","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["arthroplastyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Arthroplasty"],"published-print":{"date-parts":[[2023,9]]},"DOI":"10.1016\/j.arth.2023.02.048","type":"journal-article","created":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T07:31:38Z","timestamp":1680939098000},"page":"1839-1845.e1","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":10,"title":["Visceral Fat as a Risk Factor for Periprosthetic Joint Infection After Total Hip and Knee Arthroplasty"],"prefix":"10.1016","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3850-5982","authenticated-orcid":false,"given":"Amy Z.","family":"Blackburn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akhil","family":"Katakam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8650-950X","authenticated-orcid":false,"given":"Tyler J.","family":"Humphrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6548-5956","authenticated-orcid":false,"given":"Mehdi S.","family":"Salimy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8927-7588","authenticated-orcid":false,"given":"Cameron R.","family":"Egan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Melnic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hany S.","family":"Bedair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.arth.2023.02.048_bib1","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1007\/s11999-017-5333-6","article-title":"What is the long-term economic societal effect of periprosthetic infections after THA? A markov analysis","volume":"475","author":"Parisi","year":"2017","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2023.02.048_bib2","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/j.arth.2007.10.017","article-title":"Infection burden for hip and knee arthroplasty in the United States","volume":"23","author":"Kurtz","year":"2008","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2023.02.048_bib3","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11999-009-0825-7","article-title":"Patients with prosthetic joint infection on IV antibiotics are at high risk for readmission","volume":"467","author":"Duggal","year":"2009","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2023.02.048_bib4","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.jhin.2014.10.008","article-title":"Risk factors for periprosthetic joint infection after total joint arthroplasty: a systematic review and meta-analysis","volume":"89","author":"Zhu","year":"2015","journal-title":"J\u00a0Hosp Infect"},{"key":"10.1016\/j.arth.2023.02.048_bib5","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1186\/s12891-021-04647-1","article-title":"Patients\u2019 risk factors for periprosthetic joint infection in primary total hip arthroplasty: a meta-analysis of 40 studies","volume":"22","author":"Ren","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.arth.2023.02.048_bib6","doi-asserted-by":"crossref","first-page":"362","DOI":"10.5312\/wjo.v5.i3.362","article-title":"Identification and preoperative optimization of risk factors to prevent periprosthetic joint infection","volume":"5","author":"Baek","year":"2014","journal-title":"World J Orthop"},{"key":"10.1016\/j.arth.2023.02.048_bib7","article-title":"Preoperative optimization to prevent periprosthetic joint infection in at-risk patients","volume":"28","author":"Chan","year":"2020","journal-title":"J\u00a0Orthop Surg (Hong Kong)"},{"key":"10.1016\/j.arth.2023.02.048_bib8","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.artd.2020.04.019","article-title":"Does adherence to preoperative surgical selection criteria reduce the rate of prosthetic joint infection in primary and revision total knee arthroplasties?","volume":"6","author":"Layon","year":"2020","journal-title":"Arthroplast Today"},{"key":"10.1016\/j.arth.2023.02.048_bib9","doi-asserted-by":"crossref","first-page":"E186","DOI":"10.3390\/tropicalmed5040186","article-title":"Prevention of periprosthetic joint infection (PJI): a clinical practice protocol in high-risk patients","volume":"5","author":"Iannotti","year":"2020","journal-title":"Trop Med Infect Dis"},{"key":"10.1016\/j.arth.2023.02.048_bib10","doi-asserted-by":"crossref","first-page":"S313","DOI":"10.1016\/j.arth.2020.01.048","article-title":"BMI is a better predictor of periprosthetic joint infection risk than local measures of adipose tissue after TKA","volume":"35","author":"Shearer","year":"2020","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2023.02.048_bib11","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s00402-019-03304-6","article-title":"Risk factors for periprosthetic joint infection after total knee arthroplasty","volume":"140","author":"Blanco","year":"2020","journal-title":"Arch Orthop Trauma Surg"},{"key":"10.1016\/j.arth.2023.02.048_bib12","doi-asserted-by":"crossref","first-page":"e0150866","DOI":"10.1371\/journal.pone.0150866","article-title":"Patient-Related risk factors for periprosthetic joint infection after total joint arthroplasty: a systematic review and meta-analysis","volume":"11","author":"Kunutsor","year":"2016","journal-title":"PLoS One"},{"key":"10.1016\/j.arth.2023.02.048_bib13","doi-asserted-by":"crossref","first-page":"1964","DOI":"10.1007\/s11999.0000000000000141","article-title":"Weighing in on body mass index and infection after total joint arthroplasty: is there evidence for a body mass index threshold?","volume":"476","author":"Shohat","year":"2018","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.arth.2023.02.048_bib14","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1057\/s41285-017-0055-0","article-title":"In BMI we trust: reframing the body mass index as a measure of health","volume":"16","author":"Gutin","year":"2018","journal-title":"Soc Theor Health"},{"key":"10.1016\/j.arth.2023.02.048_bib15","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/NT.0000000000000092","article-title":"Body mass index: obesity, BMI, and health: a critical review","volume":"50","author":"Nuttall","year":"2015","journal-title":"Nutr Today"},{"key":"10.1016\/j.arth.2023.02.048_bib16","first-page":"2230","article-title":"Body mass index, physical activity, and physical fitness of adolescence","volume":"10","author":"Dewi","year":"2021","journal-title":"J\u00a0Public Health Res"},{"key":"10.1016\/j.arth.2023.02.048_bib17","doi-asserted-by":"crossref","first-page":"849","DOI":"10.2106\/JBJS.15.00509","article-title":"Percent body fat is more predictive of function after total joint arthroplasty than body mass index","volume":"98","author":"Ledford","year":"2016","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2023.02.048_bib18","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1038\/oby.2010.248","article-title":"The relationship of waist circumference and BMI to visceral, subcutaneous, and total body fat: sex and race differences","volume":"19","author":"Camhi","year":"2011","journal-title":"Obesity (Silver Spring)"},{"key":"10.1016\/j.arth.2023.02.048_bib19","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.mjafi.2017.12.001","article-title":"Correlation of visceral body fat with waist\u2013hip ratio, waist circumference and body mass index in healthy adults: a cross sectional study","volume":"76","author":"Gadekar","year":"2020","journal-title":"Med J Armed Forces India"},{"key":"10.1016\/j.arth.2023.02.048_bib20","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/j.arth.2018.02.078","article-title":"The 2018 definition of periprosthetic hip and knee infection: an evidence-based and validated criteria","volume":"33","author":"Parvizi","year":"2018","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2023.02.048_bib21","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1111\/iwj.12640","article-title":"Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta-analysis","volume":"14","author":"Kong","year":"2017","journal-title":"Int Wound J"},{"key":"10.1016\/j.arth.2023.02.048_bib22","doi-asserted-by":"crossref","first-page":"794","DOI":"10.2106\/JBJS.K.00072","article-title":"Patient-related risk factors for periprosthetic joint infection and postoperative mortality following total hip arthroplasty in Medicare patients","volume":"94","author":"Bozic","year":"2012","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2023.02.048_bib23","doi-asserted-by":"crossref","first-page":"3329","DOI":"10.1007\/s00167-015-3782-6","article-title":"Predictors of hospital readmission following revision total knee arthroplasty","volume":"24","author":"Belmont","year":"2016","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.arth.2023.02.048_bib24","series-title":"OR 2.0 context-aware operating theaters, computer assisted robotic endoscopy, clinical image-based procedures, and skin image analysis","first-page":"204","article-title":"Fully-automated analysis of body composition from CT in cancer patients using convolutional neural networks","author":"Bridge","year":"2018"},{"key":"10.1016\/j.arth.2023.02.048_bib25","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1148\/radiol.2020201640","article-title":"Population-scale CT-based body composition analysis of a large outpatient population using deep learning to derive age-, sex-, and race-specific reference curves","volume":"298","author":"Magudia","year":"2021","journal-title":"Radiology"},{"key":"10.1016\/j.arth.2023.02.048_bib26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-020-79471-z","article-title":"Optimal body size adjustment of L3 CT skeletal muscle area for sarcopenia assessment","volume":"11","author":"Derstine","year":"2021","journal-title":"Sci Rep"},{"key":"10.1016\/j.arth.2023.02.048_bib27","doi-asserted-by":"crossref","first-page":"21656","DOI":"10.1038\/s41598-021-00161-5","article-title":"Development of a fully automatic deep learning system for L3 selection and body composition assessment on computed tomography","volume":"11","author":"Ha","year":"2021","journal-title":"Sci Rep"},{"key":"10.1016\/j.arth.2023.02.048_bib28","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.ygyno.2020.10.015","article-title":"Visceral obesity and muscle mass determined by CT scan and surgical outcome in patients with advanced ovarian cancer. A retrospective cohort study","volume":"160","author":"Heus","year":"2021","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.arth.2023.02.048_bib29","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1007\/s00384-015-2174-1","article-title":"Visceral obesity determined by CT scan and outcomes after colorectal surgery; a systematic review and meta-analysis","volume":"30","author":"Cakir","year":"2015","journal-title":"Int J Colorectal Dis"},{"key":"10.1016\/j.arth.2023.02.048_bib30","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1007\/s00256-021-03866-w","article-title":"CT evaluation for sarcopenia involving the psoas and paravertebral muscles in patients with total hip arthroplasty","volume":"51","author":"Ay","year":"2022","journal-title":"Skeletal Radiol"},{"key":"10.1016\/j.arth.2023.02.048_bib31","first-page":"1143","article-title":"Skeletal muscle and fat mass indexes predict discharge disposition after radical cystectomy","volume":"202","author":"Albersheim","year":"2019","journal-title":"J\u00a0Urol"},{"key":"10.1016\/j.arth.2023.02.048_bib32","doi-asserted-by":"crossref","first-page":"319","DOI":"10.3350\/cmh.2017.0077","article-title":"Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis","volume":"24","author":"Gu","year":"2018","journal-title":"Clin Mol Hepatol"},{"key":"10.1016\/j.arth.2023.02.048_bib33","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.3346\/jkms.2006.21.6.1048","article-title":"Cut-off values of visceral fat area and waist circumference: diagnostic criteria for abdominal obesity in a Korean population","volume":"21","author":"Kim","year":"2006","journal-title":"J\u00a0Korean Med Sci"},{"key":"10.1016\/j.arth.2023.02.048_bib34","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.3899\/jrheum.170990","article-title":"Rates of total joint replacement in the United States: future projections to 2020\u20132040 using the national inpatient sample","volume":"46","author":"Singh","year":"2019","journal-title":"J\u00a0Rheumatol"},{"key":"10.1016\/j.arth.2023.02.048_bib35","doi-asserted-by":"crossref","first-page":"2440","DOI":"10.1056\/NEJMsa1909301","article-title":"Projected U.S. State-level prevalence of adult obesity and severe obesity","volume":"381","author":"Ward","year":"2019","journal-title":"New Engl J Med"},{"key":"10.1016\/j.arth.2023.02.048_bib36","first-page":"e7955","article-title":"Obesity in total hip arthroplasty: demographic disparities and outcome incongruities","volume":"12","author":"Wilkie","year":"2020","journal-title":"Cureus"},{"key":"10.1016\/j.arth.2023.02.048_bib37","doi-asserted-by":"crossref","first-page":"537","DOI":"10.2106\/JBJS.21.00514","article-title":"Trends of obesity rates between patients undergoing primary total knee arthroplasty and the general population from 2013 to 2020","volume":"104","author":"Muthusamy","year":"2022","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2023.02.048_bib38","doi-asserted-by":"crossref","first-page":"e0215035","DOI":"10.1371\/journal.pone.0215035","article-title":"Obese patients have higher rates of polymicrobial and Gram-negative early periprosthetic joint infections of the hip than non-obese patients","volume":"14","author":"L\u00f6wik","year":"2019","journal-title":"PLoS One"},{"key":"10.1016\/j.arth.2023.02.048_bib39","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.2106\/JBJS.K.00820","article-title":"The influence of obesity on the complication rate and outcome of total knee arthroplasty: a meta-analysis and systematic literature review","volume":"94","author":"Kerkhoffs","year":"2012","journal-title":"J\u00a0Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2023.02.048_bib40","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1302\/0301-620X.99B1.BJJ-2016-0346.R1","article-title":"Obesity in total hip arthroplasty: does it make a difference?","volume":"99-B","author":"Haynes","year":"2017","journal-title":"Bone Joint J"},{"key":"10.1016\/j.arth.2023.02.048_bib41","doi-asserted-by":"crossref","first-page":"e104365","DOI":"10.1371\/journal.pone.0104365","article-title":"Visceral adiposity index may Be a surrogate marker for the assessment of the effects of obesity on arterial stiffness","volume":"9","author":"Yang","year":"2014","journal-title":"PLoS One"},{"key":"10.1016\/j.arth.2023.02.048_bib42","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1038\/sc.2014.162","article-title":"Associations between abdominal visceral fat and surrogate measures of obesity in Japanese men with spinal cord injury","volume":"52","author":"Inayama","year":"2014","journal-title":"Spinal Cord"},{"key":"10.1016\/j.arth.2023.02.048_bib43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1259\/bjr\/38447238","article-title":"The clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis","volume":"85","author":"Shuster","year":"2012","journal-title":"Br J Radiol"},{"key":"10.1016\/j.arth.2023.02.048_bib44","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1186\/s12885-018-4329-2","article-title":"One-year mortality and Periprosthetic infection rates after Total knee Arthroplasty in Cancer patients: a population-based cohort study","volume":"18","author":"Kao","year":"2018","journal-title":"BMC Cancer"},{"key":"10.1016\/j.arth.2023.02.048_bib45","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.arth.2018.09.037","article-title":"Sarcopenia as a risk factor for prosthetic infection after total hip or knee arthroplasty","volume":"34","author":"Babu","year":"2019","journal-title":"J\u00a0Arthroplasty"},{"key":"10.1016\/j.arth.2023.02.048_bib46","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12891-017-1926-1","article-title":"Multi-parametric muscle and fat correlation of computed tomography parameters to outcomes in a total hip arthroplasty population","volume":"19","author":"Heffler","year":"2018","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.arth.2023.02.048_bib47","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1007\/s10350-008-9395-0","article-title":"Visceral obesity predicts surgical outcomes after laparoscopic colectomy for sigmoid colon cancer","volume":"51","author":"Tsujinaka","year":"2008","journal-title":"Dis Colon Rectum"}],"container-title":["The Journal of Arthroplasty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540323001523?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540323001523?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:45:30Z","timestamp":1760121930000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0883540323001523"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":47,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["S0883540323001523"],"URL":"https:\/\/doi.org\/10.1016\/j.arth.2023.02.048","relation":{},"ISSN":["0883-5403"],"issn-type":[{"value":"0883-5403","type":"print"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Visceral Fat as a Risk Factor for Periprosthetic Joint Infection After Total Hip and Knee Arthroplasty","name":"articletitle","label":"Article Title"},{"value":"The Journal of Arthroplasty","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arth.2023.02.048","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}