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How does IBD relate to joint infection risk?

Investigators assessed 90-day outcomes among patients with IBD who underwent elective total joint arthroplasty.

  • By

  • Kathryn Wighton

  • August 31, 2026

  • 4 min

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Clinical Report: IBD and Joint Infection Risk Post-Arthroplasty

Overview

Crohn’s disease is associated with an increased 90-day risk of periprosthetic joint infection (PJI) following total joint arthroplasty, while ulcerative colitis does not show this increased risk, according to a retrospective claims-database study. Investigators analyzed data from 2016 to 2023, highlighting significant differences in infection risk between these two forms of inflammatory bowel disease.

Background

The risk of periprosthetic joint infection (PJI) following total joint arthroplasty can significantly impact recovery and long-term outcomes. Identifying patients at higher risk allows for better management strategies.

Data Highlights

ConditionPJI CasesMatched Controls
Crohn's Disease47238
Ulcerative Colitis00

Key Findings

  • Crohn’s disease is linked to a statistically significant increased risk of PJI within 90 days post-arthroplasty.
  • No increased risk of PJI was found in patients with ulcerative colitis or in the overall IBD cohort.
  • Patients with IBD had higher risks of acute kidney injury, acute respiratory failure, sepsis, and hospital readmission.
  • Patients with Crohn’s disease specifically faced increased risks of postoperative infections and hospital readmission.
  • Study limitations include potential coding errors and inability to account for disease severity or treatment history.

Clinical Implications

Surgeons should be aware of the heightened risk of PJI in patients with Crohn’s disease.

Conclusion

The findings highlight the need for tailored surgical approaches for patients with Crohn’s disease.

Related Resources & Content

  1. Culler MW, Heckmann ND, Lieberman JR, Arthroplasty Today, 2023 -- How does IBD relate to joint infection risk?
  2. Journal of Crohn's and Colitis — Environmental risk factors of inflammatory bowel disease: toward a strategy of preventative health
  3. MDSpire News — IBD & Associated Heart Disease: Men at Higher Risk
  4. the asco post — Are Patients With Inflammatory Bowel Disease at Increased Risk for Developing Lymphoma?
  5. Archives of Toxicology — Increased Risk of Adverse Reactions to Foodborne Toxins and Medications in Patients with Inflammatory Bowel Disease: A Comprehensive Review
  6. Diagnosis and Prevention of Periprosthetic Joint Infections Evidence-Based Clinical Practice Guideline
  7. 2022 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication
  8. Inflammatory Bowel Disease and Periprosthetic Joint Infection Following Total Joint Arthroplasty: Crohn's Disease and Ulcerative Colitis Associated With Varying Risk - PubMed
  9. Inflammatory Bowel Disease and Adverse Outcomes After Total Joint Arthroplasty: A Systematic Review and Meta-Analysis.
  10. Inflammatory Bowel Disease Is Associated With Persistent Functional Impairment and Increased Short- and Long-Term Complications Following Total Knee Arthroplasty - PMC
  11. Inflammatory Bowel Disease and Risk of Periprosthetic Joint Infection After Total Joint Arthroplasty: A Systematic Review of the Current Literature.

Original Source(s)

How does IBD relate to joint infection risk?

  • by Kathryn Wighton

  • August 31, 2026

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