Crohn Disease Linked to Increased Risk for Periprosthetic Joint Infection

MONDAY, July 27, 2026 (HealthDay News) — Crohn disease (CD) is associated with an increased risk for periprosthetic joint infection (PJI) after total joint arthroplasty, according to a study published in the August issue of Arthroplasty Today.

McKenzie W. Culler, M.D., from the Keck School of Medicine of the University of Southern California in Los Angeles, and colleagues examined the relationship between inflammatory bowel disease (IBD) and PJI risk after total joint arthroplasty using data from an all-payer claims database. A total of 10,040 patients with IBD were matched to 70,203 controls. Separately 5,474 patients with CD and 4,555 patients with ulcerative colitis (UC) were matched to 38,230 and 31,865 controls, respectively.+

The researchers found that the IBD and control groups had similar PJI rates (0.71 versus 0.61 percent). However, the rate of PJI was significantly higher for patients with CD than controls (0.86 versus 0.62 percent), while the rates were similar for patients with UC and controls (0.53 versus 0.64 percent). CD was associated with increased PJI rate after adjustment for confounders (adjusted odds ratio, 1.38); in the UC and combined IBD cohorts, no increased risk was seen.

“These findings demonstrate the need for preoperative risk stratification and optimization for patients with CD prior to arthroplasty surgery,” the authors write. “Future research should aim to clarify how pathological differences between these two conditions, particularly with regard to dysbiosis and the resulting increase in gastrointestinal tract permeability, influence infectious risk.”

Several authors disclosed ties to the pharmaceutical and medical device industries.

Abstract/Full Text