The Sinus Tract Opening Count and Recorded Infection Control in Hip and Knee Prosthetic Joint Infection
- 1Department of Joint Surgery, Honghui Hospital, Xi’an Jiaotong University, No. 555 Youyi East Road, Xi’an 710054, China
Abstract
Background/Objectives: A sinus tract communicating with the prosthesis is a diagnostic criterion for periprosthetic joint infection (PJI). This study investigated the association between sinus tract opening count and recorded infection control in hip and knee PJI. Methods: We retrospectively reviewed hospital records. Firth and conventional logistic regression analyses were adjusted for treatment strategy and preoperative microbiological specimen submission. Secondary analyses included grouped counts, joint-site interaction, sensitivity analyses, propensity-score matching, and multiple-testing correction. Results: Among 189 patients, 111 had knee PJI and 78 had hip PJI. Sinus openings were present in 73 patients, including 14 with multiple openings. The numbers of patients with 1, 2, 3, and 5 openings were 59, 9, 4, and 1, respectively. Infection control was recorded in 166 patients (87.8%), with 23 failures (12.2%). Control proportions in the no-opening, single-opening, and multiple-opening groups were 91.4%, 86.4%, and 64.3%. For each additional opening, the adjusted odds ratio (OR) for infection control was 0.562 (95% confidence interval [CI]: 0.340–0.912; nominal p = 0.0209; Bonferroni-adjusted p = 0.1043). The conventional logistic estimate was similar (OR 0.543, 95% CI: 0.325–0.906; p = 0.0195). Compared with no opening, the adjusted OR for multiple openings was 0.167 (95% CI: 0.043–0.665; p = 0.0121). The comparison involving multiple sinus tract openings was exploratory and hypothesis-generating, given the small number of patients in this subgroup and the multiplicity-adjusted results. Conclusions: In patients with PJI, an increased preoperative sinus tract opening count may be associated with lower odds of recorded infection control. Future multicenter, prospective studies with standardized counting and uniform outcome definitions are needed to validate these findings.
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BibTeX
@article{zhang2026sinus,
title = {{The Sinus Tract Opening Count and Recorded Infection Control in Hip and Knee Prosthetic Joint Infection}},
author = {Wei-Song Zhang and Lin Liu and Zhi Yang and Bin-Fei Zhang},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218702},
url = {https://www.mdpi.com/2077-0383/15/21/8702},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The Sinus Tract Opening Count and Recorded Infection Control in Hip and Knee Prosthetic Joint Infection
AU - Wei-Song Zhang
AU - Lin Liu
AU - Zhi Yang
AU - Bin-Fei Zhang
PY - 2026
DA - 2026/11/07
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218702
UR - https://www.mdpi.com/2077-0383/15/21/8702
AB - Background/Objectives: A sinus tract communicating with the prosthesis is a diagnostic criterion for periprosthetic joint infection (PJI). This study investigated the association between sinus tract opening count and recorded infection control in hip and knee PJI. Methods: We retrospectively reviewed hospital records. Firth and conventional logistic regression analyses were adjusted for treatment strategy and preoperative microbiological specimen submission. Secondary analyses included grouped counts, joint-site interaction, sensitivity analyses, propensity-score matching, and multiple-testing correction. Results: Among 189 patients, 111 had knee PJI and 78 had hip PJI. Sinus openings were present in 73 patients, including 14 with multiple openings. The numbers of patients with 1, 2, 3, and 5 openings were 59, 9, 4, and 1, respectively. Infection control was recorded in 166 patients (87.8%), with 23 failures (12.2%). Control proportions in the no-opening, single-opening, and multiple-opening groups were 91.4%, 86.4%, and 64.3%. For each additional opening, the adjusted odds ratio (OR) for infection control was 0.562 (95% confidence interval [CI]: 0.340–0.912; nominal p = 0.0209; Bonferroni-adjusted p = 0.1043). The conventional logistic estimate was similar (OR 0.543, 95% CI: 0.325–0.906; p = 0.0195). Compared with no opening, the adjusted OR for multiple openings was 0.167 (95% CI: 0.043–0.665; p = 0.0121). The comparison involving multiple sinus tract openings was exploratory and hypothesis-generating, given the small number of patients in this subgroup and the multiplicity-adjusted results. Conclusions: In patients with PJI, an increased preoperative sinus tract opening count may be associated with lower odds of recorded infection control. Future multicenter, prospective studies with standardized counting and uniform outcome definitions are needed to validate these findings.
SN - 2077-0383
ER -