Extended Oral Antibiotic Prophylaxis After Aseptic Revision TKA: Does It Decrease Infection Risk?

Brandon R. Bukowski, Aaron R. Owen, Travis W. Turner, Kristin M. Fruth, Douglas R. Osmon, Mark W. Pagnano, Daniel J. Berry, Matthew P. Abdel

Research output: Contribution to journalArticlepeer-review


Background: Extended oral antibiotic prophylaxis (EOA) has been shown to potentially reduce infection rates after high-risk primary total knee arthroplasties (TKAs) and reimplantations. However, data is limited regarding EOA after aseptic revision TKAs. This study evaluated the impact of EOA on infection-related outcomes after aseptic revision TKAs. Methods: 904 aseptic revision TKAs from 2014-2019 were retrospectively identified. Patients who received EOA >24 hours perioperatively (n = 267) were compared to those who did not (n = 637) using an inverse probability of treatment weighting model. Mean age was 66 years, mean BMI was 33 kg/m2, and 54% were female. Outcomes included cumulative probabilities of any infection, periprosthetic joint infection (PJI), superficial infection, and re-revision or reoperation for infection. Results: The cumulative probability of any infection after aseptic revision TKA was 1.9% at 90 days, 3.5% at 1 year, and 8.1% at 5 years. Patients without EOA had a higher risk of any infection at 90 days (HR = 7.1; P =.01), but not other time points. The cumulative probability of PJI after aseptic revision TKA was 0.8% at 90 days, 2.3% at 1 year, and 6.5% at 5 years. Patients without EOA did not have an increased risk of PJI. There were no differences in re-revision or reoperation for infection at any time point between groups. Conclusion: Extended oral antibiotics after aseptic revision TKA were associated with a 7-fold decreased risk of any infection at 90 days. The results suggest a potential role for EOA after aseptic revision TKA and warrant additional prospective studies. Level of Evidence: Level III.

Original languageEnglish (US)
Pages (from-to)S997-S1003.e1
JournalJournal of Arthroplasty
Issue number8
StatePublished - Aug 2022


  • aseptic revision total knee arthroplasty
  • extended oral antibiotics
  • infection
  • periprosthetic joint infection
  • revision total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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