Does Symptomatic Benign Prostatic Hyperplasia Increase the Risk of Periprosthetic Joint Infection after Primary Total Joint Arthroplasty

Abstract Background Periprosthetic joint infection (PJI) is among the leading causes of failure in total joint arthroplasty. A recently proposed risk factor for PJI is symptomatic benign prostatic hyperplasia (sBPH). This study aims to determine if sBPH is associated with PJI following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods Using the Mariner all payer claims database, 1,745 patients with sBPH undergoing primary THA were propensity-matched with 3,490 controls, and 3,053 patients with sBPH undergoing primary TKA were propensity-matched with 6,106 controls. Additionally, the same 1,745 patients with sBPH undergoing THA were compared to 317,360 pre-matched controls, and the same 3,053 patients with sBPH undergoing TKA were compared to 557,730 pre-matched controls. Univariate analysis was conducted using chi-squared or ANOVA where appropriate. Results At two years postoperatively, patients with sBPH were not at significantly increased risk for PJI following primary THA (1.54% vs 1.43%; p=0.745) and TKA (1.99% vs 2.14%; p=0.642) relative to post-match controls. Compared to matched controls, THA patients with sBPH had an increased 90-day incidence of anemia (p Conclusion In primary THA and TKA, sBPH does not appear to be an independent risk factor for PJI within two years postoperatively. However, clinicians should be cognizant of the significantly increased risk for postoperative UTI in this patient population.