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Background: Disparity in access to total hip arthroplasty (THA) is an internationally recognized phenomenon influenced by social and geographical factors. The Organisation for Economic Co-operation and Development (OECD) employs the utilization rates of THA to evaluate and compare healthcare utilization by its 37 country members, including Chile. Purpose: We sought to describe THA utilization rates in the elderly Chilean population and to compare it with data from other OECD countries. In addition, we sought to identify whether sociodemographic variables influence access to THA in Chile. Methods: We conducted a retrospective review of THA cases performed in Chile between 2016 and 2018 in patients aged 65 years and older in a large database regulated by the Ministry of Health; 8970 patients were included. Mean utilization rates (MURs) of THA within Chile's 346 administrative-territorial divisions (called communes) were calculated. We analyzed associations between the communal MUR and poverty, rurality, insurance type, and geographical health administration dependency. Results: The national MUR of THA in the elderly population in Chile was 144/100,000 for the period studied. The median communal MUR was 107 (interquartile range [IQR]: 66–153). A lower MUR of THA was observed in communes with higher poverty levels, higher rurality, and a lower rates of private insurance. After negative binomial regression analysis, only rurality rate and geographical healthcare service dependency were associated with MUR. Conclusions: This retrospective database study suggests that the utilization of THA in Chile is unequal and well below the average of other OECD countries. Higher rates of rurality and administrative healthcare dependence (a geographical/administrative factor) were associated with disparities in access to THA within Chile. [ABSTRACT FROM AUTHOR]

The 2010 to 2020 decade produced remarkable advances in the understanding of periprosthetic joint infections (PJI). However, the challenges that surgeons and clinical researchers will face in the coming decade are many. Among the tactics that should comprise the strategy to keep moving forward are: (1) The incorporation of value-based healthcare concepts in PJI diagnosis. (2) Personalized approaches to estimate PJI risk and prevent it. (3) The concentration of PJI cases in multidisciplinary superspecialized units of treatment. (4) The use of a uniform definition to categorize failed and successful episodes of treatment. (5) Using the best available evidence as a benchmark to guide daily bedside decision-making.