{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:40:22Z","timestamp":1787755222490,"version":"build-2784847793"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2020,2,19]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Periprosthetic joint infection (PJI) is a severe complication with increasing incidence. However, we are not aware of any robust data on patients having PJI at the same time in \u22652 joints that had undergone total joint arthroplasty, referred to as synchronous PJI throughout this article. The aims of this study were to investigate the probability of the development of synchronous PJI of another prosthetic joint and to identify possible clinical risk factors for the development of synchronous PJI. In addition, we aimed to determine whether routine aspiration of all other prosthetic joints was warranted after a diagnosis of PJI in a single joint.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 2,532 septic revision procedures were performed during the study period. In the final analysis, 644 patients (26 with synchronous PJI and 618 with non-synchronous PJI) with 1,508 prosthetic joints were included. The mean age (and standard deviation) was 71 \u00b1 9.6 years. Using bivariate analyses, we calculated the odds of synchronous PJI as a function of various demographic and clinical variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A suspicious clinical presentation of the non-primary joint had the strongest association with synchronous PJI (odds ratio [OR], 58.5 [95% confidence interval (CI), 22.4 to 152.8]). Additional associations with synchronous PJI were detected for a history of neoplasia (OR, 12 [95% CI, 3.9 to 37.2]), the use of immune-modulating therapy (OR, 9.5 [95% CI, 3.4 to 26.2]), the presence of systemic inflammatory response syndrome or sepsis (OR, 8.4 [95% CI, 2.8 to 25]), and having \u22653 prosthetic joints (OR, 3.0 [95% CI, 1.37 to 6.64]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Synchronous PJI is a rare but very serious complication and every prosthetic joint should be investigated meticulously. Suspicious clinical presentation, a history of neoplasia, sepsis, immune-modulating therapy, and \u22653 prosthetic joints were identified as risk factors and should increase the physician\u2019s vigilance. In the case of PJI, aspiration of each joint that had undergone total joint arthroplasty should be considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.19.00835","type":"journal-article","created":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T12:34:59Z","timestamp":1576758899000},"page":"283-291","source":"Crossref","is-referenced-by-count":14,"title":["Synchronous Periprosthetic Joint Infections"],"prefix":"10.2106","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7452-4953","authenticated-orcid":false,"given":"Darius M.","family":"Thiesen","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany"},{"name":"Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7102-9885","authenticated-orcid":false,"given":"Seval","family":"Mumin-G\u00fcnd\u00fcz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany"},{"name":"Department of Surgery, Ruhr-University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6897-2971","authenticated-orcid":false,"given":"Thorsten","family":"Gehrke","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0181-188X","authenticated-orcid":false,"given":"Ianiv","family":"Klaber","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9738-2305","authenticated-orcid":false,"given":"Jochen","family":"Salber","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ruhr-University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7578-8440","authenticated-orcid":false,"given":"Eduardo","family":"Suero","sequence":"additional","affiliation":[{"name":"Department of General, Trauma and Reconstructive Surgery, Ludwig Maximilian University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3207-7101","authenticated-orcid":false,"given":"Mustafa","family":"Citak","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,12,19]]},"reference":[{"issue":"5","key":"bib1-20230810","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 Arthroplasty."},{"issue":"3","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.arth.2017.10.024","article-title":"Risk of periprosthetic joint infection in patients with multiple arthroplasties","volume":"33","author":"Abblitt","year":"2018","journal-title":"J Arthroplasty."},{"issue":"10","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.2106\/00004623-199173100-00004","article-title":"Metachronous infections in patients who have had more than one total joint arthroplasty","volume":"73","author":"Murray","year":"1991","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/j.arth.2012.01.002","article-title":"Periprosthetic joint infection: are patients with multiple prosthetic joints at risk?","volume":"27","author":"Jafari","year":"2012","journal-title":"J Arthroplasty."},{"issue":"7","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/S0883-5403(96)80189-6","article-title":"Multiple prosthetic infections after total joint arthroplasty. 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