Dean C Perfetti1, Matthew R Boylan2, Qais Naziri1, Carl B Paulino1, Steven M Kurtz3, Michael A Mont4. 1. Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York. 2. Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York; Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York. 3. Implant Research Center, School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, Pennsylvania. 4. Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
Abstract
BACKGROUND: Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). Although the number of revision cases is increasing, the prevalence of PJI as an indication for revision surgery, and the variability of this indication among surgeons and hospitals, is unclear. METHODS: The New York Statewide Planning and Research Cooperative System was used to identify 33,582 patients undergoing revision THA between 2000 and 2013. PJI was identified using International Classification of Diseases, Ninth Revision diagnosis codes. Volume was defined using mean number of revision THAs performed annually by each hospital and surgeon. RESULTS: PJI was the indication for 13.0% of all revision THAs. The percentage of revision THAs for PJI increased between years 2000 and 2007 (odds ratio [OR] = 1.05, P < .001), but decreased between years 2008 and 2013 (OR = 0.96, P = .001). Compared to medium-volume hospitals, the PJI burden at high-volume hospitals decreased during years 2000-2007 (OR = 0.58, P < .001) and 2008-2013 (OR = 0.57, P < .001). Compared to medium-volume surgeons, the PJI burden for high-volume surgeons increased during years 2000-2007 (OR = 1.39, P < .001), but did not differ during years 2008-2013 (P = .618). CONCLUSION: The burden of PJI as an indication for revision THA may be plateauing. High-volume institutions have seen decreases in the percentage of revisions performed for PJI over the complete study duration. Specific surgeon may be associated with the plateauing in PJI rates as high-volume surgeons in 2008-2013 were no longer found to be at increased risk of PJI as an indication for revision THA.
BACKGROUND: Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). Although the number of revision cases is increasing, the prevalence of PJI as an indication for revision surgery, and the variability of this indication among surgeons and hospitals, is unclear. METHODS: The New York Statewide Planning and Research Cooperative System was used to identify 33,582 patients undergoing revision THA between 2000 and 2013. PJI was identified using International Classification of Diseases, Ninth Revision diagnosis codes. Volume was defined using mean number of revision THAs performed annually by each hospital and surgeon. RESULTS: PJI was the indication for 13.0% of all revision THAs. The percentage of revision THAs for PJI increased between years 2000 and 2007 (odds ratio [OR] = 1.05, P < .001), but decreased between years 2008 and 2013 (OR = 0.96, P = .001). Compared to medium-volume hospitals, the PJI burden at high-volume hospitals decreased during years 2000-2007 (OR = 0.58, P < .001) and 2008-2013 (OR = 0.57, P < .001). Compared to medium-volume surgeons, the PJI burden for high-volume surgeons increased during years 2000-2007 (OR = 1.39, P < .001), but did not differ during years 2008-2013 (P = .618). CONCLUSION: The burden of PJI as an indication for revision THA may be plateauing. High-volume institutions have seen decreases in the percentage of revisions performed for PJI over the complete study duration. Specific surgeon may be associated with the plateauing in PJI rates as high-volume surgeons in 2008-2013 were no longer found to be at increased risk of PJI as an indication for revision THA.
Authors: Mitchell Ng; Simeng Song; Jaiben George; Anton Khlopas; Nipun Sodhi; Kenneth Ng; Assem A Sultan; Nicolas S Piuzzi; Michael A Mont Journal: Ann Transl Med Date: 2017-12
Authors: Christopher E Kandel; Richard Jenkinson; Nick Daneman; David Backstein; Bettina E Hansen; Matthew P Muller; Kevin C Katz; Jessica Widdifield; Earl Bogoch; Sarah Ward; Abhilash Sajja; Felipe Garcia Jeldes; Allison McGeer Journal: Open Forum Infect Dis Date: 2019-10-21 Impact factor: 3.835
Authors: Hong Seok Kim; Jung Wee Park; Sun Young Moon; Young Kyun Lee; Yong Chan Ha; Kyung Hoi Koo Journal: J Korean Med Sci Date: 2020-12-21 Impact factor: 2.153
Authors: Jonathan Bourget-Murray; Rohit Bansal; Alexandra Soroceanu; Sophie Piroozfar; Pam Railton; Kelly Johnston; Andrew Johnson; James Powell Journal: J Bone Jt Infect Date: 2021-12-08