Economic Burden of Periprosthetic Joint Infection Following Primary Total Knee Replacement in a Developing Country.

Faizan Iqbal, Bilal Shafiq, Syed Shahid Noor, Zulfiqar Ali, Nouman Memon, Naveed Memon
Author Information
  1. Faizan Iqbal: Department of Orthopedic Surgery Liaquat National Hospital and Medical College, Karachi, Pakistan.
  2. Bilal Shafiq: Department of Orthopedic Surgery Liaquat National Hospital and Medical College, Karachi, Pakistan.
  3. Syed Shahid Noor: Department of Orthopedic Surgery Liaquat National Hospital and Medical College, Karachi, Pakistan.
  4. Zulfiqar Ali: Department of Orthopedic Surgery Liaquat National Hospital and Medical College, Karachi, Pakistan.
  5. Nouman Memon: Department of Orthopedic Surgery Liaquat National Hospital and Medical College, Karachi, Pakistan.
  6. Naveed Memon: Department of Orthopedic Surgery Liaquat National Hospital and Medical College, Karachi, Pakistan.

Abstract

BACKGROUND: Periprosthetic joint infection is one of the devastating complications after primary total knee arthroplasty, which increases the financial burden on patients and affects their quality of life as well. The financial burden of periprosthetic joint infection after joint replacement in developed countries is well known. There is a need to evaluate the economic burden in developing countries such as Pakistan.
METHODS: This is a single-center, retrospective, case-control study conducted at the Department of Orthopedic Surgery, Liaquat National Hospital Karachi. Cases of primary total knee arthroplasty performed during this study were divided into 2 groups: uneventful primary total knee arthroplasty and periprosthetic joint infection treated with 2-stage revision. To calculate the final cost, we divided the total hospital cost into the hospital stay cost and operating room cost.
RESULTS: During study period, 32 patients were diagnosed with periprosthetic joint infection. The total cost of revision surgery for periprosthetic joint infection considering 2 hospitalizations was 1,780,222 ± 313,686 Pakistani rupee (PKR). The total cost of uneventful arthroplasty was 390,172 ± 51,460 PKR. We observed significant difference with respect to economic details between the 2 groups.
CONCLUSIONS: Management of periprosthetic joint infection was 4.5 times more expensive than uneventful primary total knee arthroplasty. Measures should be undertaken to reduce the prevalence of periprosthetic joint infection, thereby reducing patients' economic burden.

Keywords

References

  1. Antimicrob Resist Infect Control. 2015 May 15;4:13 [PMID: 28428876]
  2. Clin Microbiol Infect. 2013 Feb;19(2):181-6 [PMID: 22264335]
  3. Hip Pelvis. 2017 Sep;29(3):176-181 [PMID: 28955683]
  4. Bone Joint J. 2015 Aug;97-B(8):1076-81 [PMID: 26224824]
  5. Open Orthop J. 2013 Jun 14;7:227-42 [PMID: 24082966]
  6. J Arthroplasty. 2013 Aug;28(7):1057-60 [PMID: 23523484]
  7. J Arthroplasty. 2012 Sep;27(8 Suppl):61-5.e1 [PMID: 22554729]
  8. Am J Infect Control. 2008 Jun;36(5):309-32 [PMID: 18538699]
  9. Am J Infect Control. 2009 Jun;37(5):387-397 [PMID: 19398246]
  10. SICOT J. 2019;5:5 [PMID: 30816089]
  11. JAMA Surg. 2017 Aug 1;152(8):784-791 [PMID: 28467526]
  12. Acta Orthop. 2012 Oct;83(5):449-58 [PMID: 23083433]
  13. Lancet Infect Dis. 2016 Dec;16(12):e276-e287 [PMID: 27816413]
  14. JAMA. 2018 Mar 13;319(10):1024-1039 [PMID: 29536101]
  15. Bone Joint Res. 2016 Aug;5(8):328-37 [PMID: 27496913]
  16. Infect Control Hosp Epidemiol. 2002 Apr;23(4):183-9 [PMID: 12002232]
  17. Indian J Anaesth. 2011 Mar;55(2):111-5 [PMID: 21712864]
  18. J Arthroplasty. 2014 May;29(5):929-32 [PMID: 24140271]

MeSH Term

Arthroplasty, Replacement, Knee
Case-Control Studies
Cost of Illness
Developing Countries
Female
Humans
Male
Middle Aged
Postoperative Complications
Prosthesis-Related Infections
Quality of Life
Reoperation
Retrospective Studies

Word Cloud

Created with Highcharts 10.0.0jointinfectiontotalarthroplastyperiprostheticcostkneeburdenprimaryPeriprostheticeconomicstudy2uneventfulfinancialpatientswellcountriesdividedrevisionhospitalsurgery±PKREconomicTotalBACKGROUND:onedevastatingcomplicationsincreasesaffectsqualitylifereplacementdevelopedknownneedevaluatedevelopingPakistanMETHODS:single-centerretrospectivecase-controlconductedDepartmentOrthopedicSurgeryLiaquatNationalHospitalKarachiCasesperformedgroups:treated2-stagecalculatefinalstayoperatingroomRESULTS:period32diagnosedconsideringhospitalizations1780222313686Pakistanirupee39017251460observedsignificantdifferencerespectdetailsgroupsCONCLUSIONS:Management45timesexpensiveMeasuresundertakenreduceprevalencetherebyreducingpatients'BurdenJointInfectionFollowingPrimaryKneeReplacementDevelopingCountryRevision

Similar Articles

Cited By