The economic impact of periprosthetic infection in total knee arthroplasty

Abstract

Background: Currently, the gold standard treatment for periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) is 2-stage revision, but few studies have looked at the economic impact of PJI on the health care system. The objective of this study was to obtain an accurate estimate of the institutional cost associated with the management of PJI in TKA and to assess the economic impact of PJI after TKA compared to uncomplicated primary TKA. Methods: We identified consecutive patients in our institutional database who had undergone 2-stage revision TKA for PJI between 2010 and 2014 and matched them on age and body mass index with patients who had undergone uncomplicated primary TKA over the same period. We calculated all costs associated with the 2 procedures and compared mean costs, length of stay, clinical visits and readmission rates between the 2 groups. Results: There were 73 patients (mean age 68.8 [range 48–91] yr) in the revision TKA cohort and 73 patients (mean age 65.9 [range 50–86] yr) in the primary TKA cohort. Two-stage revision surgery was associated with a significantly longer hospital stay (mean 22.7 d v. 3.84 d, p <s; 0.001), more outpatient clinic visits (mean 8 v. 3, p < 0.001), more readmissions (29 v. 0, p < 0.001) and higher overall cost (mean $35 429.97 v. $6809.94, p < 0.001) than primary TKA. Conclusion: Treatment for PJI after TKA has an enormous economic impact on the health care system. Our data suggest a fivefold increase in expenditure in the management of this complication compared to uncomplicated primary TKA.

The efficacy of antibiotic‐eluting material in a two‐stage model of periprosthetic joint infection

“…Periprosthetic joint infections (PJI) occur in about 2% of the >1 million patients undergoing joint replacement in the United States each year 1 . Revisions due to this morbid complication cost five times more than primary surgeries 2 and the mortality of PJI patients are akin to some cancers 3 . Thus, PJI is a condition with a high quality‐of‐life burden on patients and an economic burden to the healthcare system.…”

Prosthetic Knee Joint Infection by Brucella melitensis

“…Infection is the major cause of early revision following total knee arthroplasty, accounting for 25.4% of revisions within the first two years and 7.8% of revisions after two years postoperatively [3]. Meanwhile, the treatment of prosthetic joint infections has a huge financial impact on healthcare systems [4]. Among pathogens related to prosthetic joint infections, Brucella species are uncommon, with few reports being published in recent literature.…”

What’s New in Musculoskeletal Infection

“…In a study utilizing the National Inpatient Sample (NIS), Premkumar et al projected that, by 2030, the annual hospital costs related to PJI of the hip and knee will equal $1.85 billion in the United States 6 . In another study from a single institution, the cost of care for a PJI after a 2-stage total knee arthroplasty (TKA) was more than 5 times the cost of care of an uncomplicated primary TKA for an age-matched and body mass index (BMI)-matched cohor t 7 . Comparing the cost of operative treatment for PJI of the hip and knee with that of aseptic revision, Yao et al 8 showed that the PJI treatment had costs that were double those of the aseptic treatment.…”