title: The economic impact of periprosthetic infections following total knee arthroplasty at a specialized tertiary-care center.
abstract: The purpose of this study was to measure the impact of periprosthetic joint infections (PJIs) on the length of hospitalization, readmissions, and the associated costs. Between 2007 and 2011, our prospectively collected infection database was reviewed to identify PJIs that occurred following primary total knee arthroplasty (TKA), which required a two-stage revision. We identified 21 consecutive patients and matched them to 21 non-infected patients who underwent uncomplicated primary TKA. The patients who had PJIs had significantly longer hospitalizations (5.3 vs. 3.0 days), more readmissions (3.6 vs. 0.1), and more clinic visits (6.5 vs. 1.3) when compared to the matched group, respectively. The mean annual cost was significantly higher in the infected cohort ($116,383; range, $44,416 to $269,914) when compared to the matched group ($28,249; range, $20,454 to $47,957). Periprosthetic infections following TKA represent a tremendous economic burden for tertiary-care centers and to patients.
authors.affiliation: Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Bhaveen H
authors.initials: BH
authors.lastname: Kapadia
authors.affiliation: Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: McElroy
authors.affiliation: Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Kimona
authors.initials: K
authors.lastname: Issa
authors.affiliation: Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Johnson
authors.affiliation: Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Bozic
authors.affiliation: Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000553:Ambulatory Care / Q000191:economics; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000191:economics; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D010359:Patient Readmission / Q000191:economics; D016459:Prosthesis-Related Infections / Q000191:economics* / Q000209:etiology; D013530:Surgical Wound Infection / Q000191:economics*; D062606:Tertiary Care Centers / Q000191:economics*; D014481:United States / Q000453:epidemiology
keywords: economic analysis; healthcare costs; periprosthetic infection; surgical site infection; total knee arthroplasty