Surgery for prosthetic joint infection (PJI) can often lead to significant blood loss, necessitating allogeneic blood transfusion (ABT). The use of ABT is associated with higher rates of morbidity and death in revision total joint arthroplasty, particularly in the treatment of PJI. We compared ABT rates by procedure type among patients treated for PJI. We retrospectively reviewed 143 operative cases of hip and knee PJI performed at our institution between 2016 and 2018. Procedures were categorized as irrigation and debridement (I&D) with modular component exchange (modular component exchange), explantation with I&D and placement of an antibiotic spacer (explantation), I&D with antibiotic spacer exchange (spacer exchange), or antibiotic spacer removal and prosthetic reimplantation (reimplantation). Rates of ABT and the number of units transfused were assessed. Factors associated with ABT were assessed with a multilevel mixed-effects regression model. Of the cases, 77 (54%) required ABT. The highest rates of ABT occurred during explantation (74%) and spacer exchange (72%), followed by reimplantation (36%) and modular component exchange (33%). A lower preoperative hemoglobin level was associated with higher odds of ABT. Explantation, reimplantation, and spacer exchange were associated with greater odds of ABT. Antibiotic spacer exchange and explantation were associated with greater odds of multiple-unit transfusion. Rates of ABT remain high in the surgical treatment of PJI. Antibiotic spacer exchange and explantation procedures had high rates of multiple-unit transfusions, and additional units of blood should be made available. Preoperative anemia should be treated when possible, and further refinement of blood management protocols for prosthetic joint infection is necessary. [Orthopedics. 20XX;XX(X):xx–xx.]

人工关节感染 (PJI) 手术通常会导致大量失血，需要异体输血 (ABT)。ABT 的使用与翻修全关节置换术中较高的发病率和死亡率相关，特别是在 PJI 的治疗中。我们在接受 PJI 治疗的患者中按手术类型比较了 ABT 率。我们回顾性回顾了 2016 年至 2018 年间在我们机构进行的 143 例髋关节和膝关节 PJI 手术病例。手术被归类为冲洗和清创术 (I&D) 与模块化组件交换 (modular component exchange)、I&D 外植和放置抗生素间隔器 (外植）、I&D 与抗生素垫片交换（spacer exchange），或抗生素垫片移除和假体再植入（reimplantation）。评估了 ABT 率和输血单位数。使用多级混合效应回归模型评估与 ABT 相关的因素。在这些案例中，77 例 (54%) 需要 ABT。ABT 的发生率最高发生在外植 (74%) 和垫片交换 (72%) 期间，其次是再植入 (36%) 和模块化组件交换 (33%)。较低的术前血红蛋白水平与较高的 ABT 几率相关。外植、再植入和垫片交换与 ABT 的更大几率相关。抗生素间隔物交换和外植与更大的多单位输血几率相关。在 PJI 的手术治疗中，ABT 的发生率仍然很高。抗生素间隔物交换和外植手术的多单位输血率很高，应该提供额外单位的血液。应尽可能治疗术前贫血，并且有必要进一步完善人工关节感染的血液管理方案。[骨科。20XX;XX(X):xx–xx.]