In The Journal of arthroplasty ; h5-index 65.0
BACKGROUND : Visceral obesity, a strong indicator of chronic inflammation and impaired metabolic health, has been shown to be associated with poor postoperative outcomes and complications. This study aimed to evaluate the relationship between visceral fat area (VFA) and periprosthetic joint infection (PJI) in total joint arthroplasty (TJA) patients.
METHODS : A retrospective study of 484 patients who had undergone a total hip or knee arthroplasty was performed. All patients had a computed tomography scan of the abdomen/pelvis within two years of their TJA. Body composition data (i.e., visceral fat area (VFA), subcutaneous fat area, and skeletal muscle area) was calculated at the Lumbar-3 vertebral level via two fully automated and externally validated machine learning algorithms. A multivariable logistic model was created to determine the relationship between VFA and PJI, while accounting for other PJI risk factors. Of the 484 patients, 31 (6.4%) had a PJI complication.
RESULTS : The rate of PJI among patients with VFA in the top quartile (>264.1 cm2) vs bottom quartile (<82.6 cm2) was 5.6 vs 10.6%, and 18.8 vs 2.7% in the THA and TKA cohorts, respectively. In the multivariate model, TKA patients with a VFA in the top quartile had a 30.5 times greater risk of PJI than those in the bottom quartile of VFA (p=0.0154).
CONCLUSION : Visceral fat area may have a strong association with PJI in TJA patients. Using a standardized imaging modality like computed tomography scans to calculate VFA can be a valuable tool for surgeons when assessing risk of PJI.
Blackburn Amy Z, Katakam Akhil, Roberts Thomas, Melnic Christopher M, Humphrey Tyler J, Salimy Mehdi Sina, Egan Cameron R, Bedair Hany S
2023-Feb-27
body composition, computed tomography scan, periprosthetic joint infection, risk factor, total joint arthroplasty, visceral fat
