{
  "abstract": "Background and Aims As primary total hip/knee arthroplasty (THA/TKA) volumes rise, revision surgeries are also increasing. While neuraxial anesthesia (NA) is well studied in primary procedures, its use in revisions, especially those due to periprosthetic joint infection (PJI), remains less understood. PJI may influence anesthesia choice due to the risks of central nervous system (CNS) infection, though evidence is limited. We examined trends in the use of NA among revision THA and TKA recipients from 2013 to 2023, stratified by PJI as indication.Methods Using the Premier Healthcare Database from 2013–2023, we identified 166,755 revision TKAs and 116,300 revision THAs. PJI was identified via ICD codes, and anesthesia type was classified using billing codes. The cohort was stratified by PJI status and trends were analyzed using Cochran-Armitage tests.Results PJI incidence rose over time for both procedure types (THA: 16.3% to 27.6%, TKA: 26.5% to 36.5%). NA use was consistently lower in PJI vs. non-PJI cases (THA: 8.9% vs. 14.1%, TKA: 10.3% vs. 18.7%; both p<0.0001). NA use declined over time in TKA revisions due to PJI (p = 0.002), remained stable in TKA revisions due to PJI (p = 0.66), and increased in THA revisions regardless of infection status (p = 0.018 and p = 0.003).Abstract OP44 Figure 1Neuraxial anesthesia use for TKA and THA revisions, stratified by PJI statusConclusions Despite potential benefits, NA remains underused in revision THA/TKA, especially with PJI. This may reflect ongoing CNS infection concerns, though actual risk appears low according to the literature. These findings highlight the need for clearer guidelines and more robust evidence to support anesthesia decision-making in revision arthroplasty, particularly in PJI cases.",
  "authors": [
    {
      "affiliations": [
        "Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Juliet Rowe"
    },
    {
      "affiliations": [
        "Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Periklis Giannakis"
    },
    {
      "affiliations": [
        "Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Alex Illescas"
    },
    {
      "affiliations": [
        "Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Jiabin Liu"
    },
    {
      "affiliations": [
        "Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Stavros Memtsoudis"
    },
    {
      "affiliations": [
        "Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Daniel Maalouf"
    },
    {
      "affiliations": [
        "Anesthesiology, Critical Care, and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Jashvant Poeran"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Critical Care, and Pain Medicine, Paracelsus Medical University, Salzburg, Austria"
      ],
      "name": "Crispiana Cozowicz"
    }
  ],
  "title": "OP44 Neuraxial anesthesia in revision hip and knee arthroplasties stratified by prosthetic joint infection status: a trend analysis",
  "uid": "f39cabff-c039-5b04-98eb-e7f50163432b"
}