Study: Infection risk unaffected by colonoscopy, joint replacement timing

Editor's Note

A study published May 7 in JAMA Open found no significant risk of periprosthetic joint infection (PJI) when colonoscopy is performed within one year of total joint arthroplasty (TJA), whether the colonoscopy was done before or after the surgery. However, certain comorbidities such as kidney and pulmonary disease, diabetes, and inflammatory conditions were identified as significant risk factors for PJI. Based on the results, patients should not delay TJA or routine colonoscopy due to concerns about PJI risk, researchers write. However, they caution that patients with specific comorbidities should carefully consider timing between the procedures.

The study analyzed data from Military Health System beneficiaries who underwent TJA between 2010 and 2016. Among 243,671 patients, 144,083 underwent TJA. In the preoperative colonoscopy cohort, 325 patients (2.8%) had PJI within 1 year. In the postoperative colonoscopy cohort, 138 patients (1.8%) had PJI within 1 year. Younger age, male sex, and several chronic health conditions (diabetes, kidney disease, and pulmonary disease) were each associated with higher PJI risk.  ).

Periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) is a rare yet serious complication linked to higher morbidity and mortality rates, researchers write, adding that incidence is likely to increase along with the demand for the surgery.  Additionally, the aging US population and guidelines calling for routine colonoscopy screening starting at 45 years old will result in more individuals requiring the routine procedure.