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Regional Periprosthetic Joint Infection Centers: The Time Has Come for a Paradigm Change in the Treatment of Periprosthetic Joint Infection.
- Source :
-
The Journal of arthroplasty [J Arthroplasty] 2024 Dec; Vol. 39 (12), pp. 2887-2892. Date of Electronic Publication: 2024 Jul 31. - Publication Year :
- 2024
-
Abstract
- Background: Periprosthetic joint infection (PJI) is a rare, yet devastating complication with high mortality rates, unpredictable treatment outcomes, and high costs. The purpose of this study was to determine 90-day and 1-year mortality rates at a specialized PJI center, assess the impact of delayed referral to a PJI center on outcomes, and determine the cost of PJI treatment prior to referral to a PJI center.<br />Methods: A review of our institution's PJI registry was performed to identify patients who had a chronic PJI treated with a 2-stage exchange arthroplasty at our PJI Center from 2017 to 2021. Patients not referred from an external location were excluded. Mortality at 90 days and 1 year was collected. The date of infection diagnosis until the date of referral was recorded. Outcomes were documented as failure of treatment at the final clinical follow-up. The number and type of prior infection treatments were documented for each patient. The estimated cost was calculated using established PJI literature.<br />Results: There were 172 patients (182 joints) who met inclusion criteria during this timeframe. The 90-day and 1-year mortality rates were 0 and 3.9%, respectively. There was a higher failure rate in patients referred >90 days after the diagnosis of chronic PJI (23 versus 11%, P = 0.031). The total cost of PJI treatment prior to referral for this group of patients was $6.9 million.<br />Conclusions: Implementation of a specialized PJI referral center leads to lower mortality rates, improved outcomes, and decreased cost for the health-care system.<br /> (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Male
Female
Aged
Middle Aged
Retrospective Studies
Registries
Referral and Consultation
Aged, 80 and over
Reoperation statistics & numerical data
Treatment Outcome
Anti-Bacterial Agents therapeutic use
Adult
Arthroplasty, Replacement, Hip adverse effects
Prosthesis-Related Infections therapy
Prosthesis-Related Infections economics
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8406
- Volume :
- 39
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The Journal of arthroplasty
- Publication Type :
- Academic Journal
- Accession number :
- 39089394
- Full Text :
- https://doi.org/10.1016/j.arth.2024.07.034