Periprosthetic Joint Infection Can Cause Abnormal Systemic Coagulation

Surgery may often be needed for treatment of patients with a periprosthetic joint infection (PJI). This study intended to evaluate the incidence of abnormal coagulation and determine the efficacy of treatment of reversing a coagulation abnormality in patients with PJI. The cohort included 294 patients undergoing treatment of PJI at our institution from 1998 to 2005. In our final analysis, 72 patients (56%) had abnormal coagulation (defined as international normalized ratio >1.12). Fresh frozen plasma and/or vitamin K were administered to 29 of these patients (40%). The international normalized ratio was normalized in only 7 (24.1%) of the latter patients. It appears that more than one half of patients with PJI may have abnormal coagulation even without being exposed to anticoagulation agents, highlighting the possibility that patients with PJI may have circulating levels of biologically active agents that affect coagulation.