Prosthetic Joint Infections and Cost Analysis?

Abstract

Prosthetic joint infection is a devastating complication of arthroplasty surgery that can lead to debilitating morbidity for the patient and significant expense for the healthcare system. With the continual rise of arthroplasty cases worldwide every year, the revision load for infection is becoming a greater financial burden on healthcare budgets. Prevention of infection has to be the key to reducing this burden. For treatment, it is critical for us to collect quality data that can guide future management strategies to minimise healthcare costs and morbidity / mortality for patients. There has been a management shift in many countries to a less expensive 1-stage strategy and in selective cases to the use of debridement, antibiotics and implant retention. These appear very attractive options on many levels, not least cost. However, with a consensus on the definition of joint infection only clarified in 2011, there is still the need for high quality cost analysis data to be collected on how the use of these different methods could impact the healthcare expenditure of countries around the world. With a projected spend on revision for infection at US$1.62 billion in the US alone, this data is vital and urgently needed.

Cost-analysis of inpatient and outpatient parenteral antimicrobial therapy in orthopaedics: A systematic literature review

“…They are associated with significant socio-economic costs. Haddad et al[6] estimate the costs of PPJI to be approximately $1.62 billion (approx. €1.4 billion).…”

“…Usually, parenteral therapy requires an inpatient setting [Inpatient parenteral antibiotic therapy (IPAT)] due to monitoring, need for intravenous lines and administration of detergents by healthcare providers. This inpatient therapy goes along with high direct as well as indirect costs for the health system[6]. An alternative to IPAT is outpatient parenteral treatment [Outpatient parenteral antibiotic therapy (OPAT)].…”

Association between Allogeneic Blood Transfusion and Wound Infection after Total Hip or Knee Arthroplasty: A Retrospective Case-Control Study

“…Peri-prosthetic joint infections (PJIs) are the most disastrous complications of total hip or knee arthroplasty 1,2. Besides the increased morbidity and mortality for patients, these infections are a huge burden on healthcare resources1,2. A significant volume of research is being done in accurately diagnosing PJIs3,4.…”

Intrawound vancomycin in primary hip and knee arthroplasty: a safe and cost-effective means to decrease early periprosthetic joint infection

“…Despite substantial research and robust multimodal programs to mitigate infection, periprosthetic joint infection (PJI) continues to be a devastating complication to patients and the health-care system. PJI rates have continued to average between 0.5 and 2% [2] , [3] , [4] , and it is estimated that by 2020, $1.62 billion will be spent on revisions for infection in the United States alone [5] .…”