{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:57:59Z","timestamp":1790279879599,"version":"4.1.0"},"reference-count":62,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Rheumatoid arthritis (RA) is a risk factor for periprosthetic joint infection (PJI) after total joint arthroplasty (TJA). The purpose of this study was to perform a systematic review comparing the failure rates of debridement, antibiotics, and implant retention (DAIR), one-stage exchange arthroplasty\/revision (OSR), and 2-stage exchange arthroplasty\/revision (TSR) for RA patients with PJI and identify risk factors in the RA population associated with increased treatment failure rate.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n PubMed, Ovid MEDLINE, and Ovid Embase databases were screened with the terms \u201crheumatoid arthritis,\u201d \u201ctotal joint arthroplasty,\u201d \u201cprosthetic joint infection,\u201d and \u201ctreatment for PJI\u201d on August 29, 2021. Four hundred ninety-one studies were screened, of which 86 were evaluated. The primary outcome evaluated was failure of surgical treatment for PJI.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Ten retrospective cohort studies were included after full-text screening, yielding 401 patients with RA. Additional demographic and PJI management data were obtained for 149 patients. Patients with RA who underwent TSR demonstrated a lower failure rate (26.8%) than both DAIR (60.1%) and OSR (39.2%) (\u03c7\n 2<\/jats:sup>\n = 37.463, p < 0.00001). Patients with RA who underwent DAIR had a 2.27 (95% CI, 1.66-3.10) times higher risk of experiencing treatment failure than those who underwent TSR. Among risk factors, there was a significant difference in the C-reactive protein of patients who did vs. did not experience treatment failure (p = 0.02).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n TSR has a higher rate of success in the management of PJI patients with RA compared with DAIR and OSR. The complete removal of the infected prosthesis and delayed reimplantation may lower the treatment failure rate.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n \n 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.rvw.23.00124","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T14:00:47Z","timestamp":1708005647000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["What Is the Most Effective Treatment for Periprosthetic Joint Infection After Total Joint Arthroplasty in Patients with Rheumatoid Arthritis?"],"prefix":"10.2106","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0059-8160","authenticated-orcid":false,"given":"Vineet","family":"Desai","sequence":"first","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Orthopaedic Surgery, Brigham & Women's Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4558-3900","authenticated-orcid":false,"given":"Alexander R.","family":"Farid","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Orthopaedic Surgery, Brigham & Women's Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8699-0292","authenticated-orcid":false,"given":"Adriana P.","family":"Liimakka","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Orthopaedic Surgery, Brigham & Women's Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5541-5084","authenticated-orcid":false,"given":"Jaime","family":"Lora-Tamayo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario 12 de Octubre, Instituto de Investigaci\u00f3n Biom\u00e9dica im\u00e1s12, CIBER de Enfermedades Infecciosas (CIBERINFEC, Instituto de Salud Carlos III), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7866-2467","authenticated-orcid":false,"given":"Marjan","family":"Wouthuyzen-Bakker","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4173-4786","authenticated-orcid":false,"given":"Jesse W.P.","family":"Kuiper","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Martini Hospital, Groningen, the 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