Psoriasis as a Risk Factor for Surgical Site Infection Following Primary Total Knee Arthroplasty

According to a study published in Clinical Orthopaedics and Related Research, psoriasis is a risk factor for superficial surgical site infection (SSI) after primary total knee arthroplasty (TKA) and is an important comorbidity for surgeons to consider before surgery.

Researchers aimed to evaluate the association between psoriasis and postoperative complications, specifically superficial and deep SSI, following primary TKA. Utilizing data from the PearlDiver database, which included 248 492 patients who underwent unilateral primary TKA between 2015 and 2019, researchers compared outcomes between patients with psoriasis (n = 1078) and a control group without psoriasis (n = 247 414).

After adjusting for potential confounders, such as age, sex, comorbidities, and insurance status, patients with psoriasis exhibited higher odds of overall SSI compared to those without psoriasis. Specifically, the odds of superficial SSI were significantly elevated in the psoriasis group, whereas no significant difference was observed in the odds of deep SSI between the 2 cohorts. Furthermore, patients with psoriasis did not demonstrate increased odds of undergoing aseptic revision or manipulation under anesthesia compared to the control group. Patients with psoriasis had higher overall rates of SSI at 2 years of follow-up than patients without psoriasis.

“Further research is needed to assess the role of adjunctive interventions in patients with psoriasis to mitigate the elevated odds of superficial SSI,” the authors concluded.

Reference
Durst C, Rajaee L, Chang K, Lee A, Rajaee S. Psoriasis is a risk factor for surgical site infection after primary TKA. Clin Orthop Relat Res. Published online February 20, 2024. doi:10.1097/CORR.0000000000003011