The health-economic burden of hip and knee periprosthetic joint infections in Europe: a comprehensive analysis following primary arthroplasty
Aims: Periprosthetic joint infections (PJIs) pose significant challenges to patients and healthcare systems worldwide. The aim of this study was to estimate the health-economic burden of reimbursement payment in Europe for PJIs following primary hip and knee arthroplasty. Methods: The calculation...
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The British Editorial Society of Bone & Joint Surgery
2025-03-01
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| Series: | Bone & Joint Open |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.63.BJO-2024-0225.R1 |
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| author | Volker Alt Dominik Szymski Markus Rupp Andreas Fontalis Danguole Vaznaisiene Leonard C. Marais Christof Wagner Nike Walter on behalf the Country Delegates of the European Bone and Joint Infection Society* |
| author_facet | Volker Alt Dominik Szymski Markus Rupp Andreas Fontalis Danguole Vaznaisiene Leonard C. Marais Christof Wagner Nike Walter on behalf the Country Delegates of the European Bone and Joint Infection Society* |
| author_sort | Volker Alt |
| collection | DOAJ |
| description | Aims: Periprosthetic joint infections (PJIs) pose significant challenges to patients and healthcare systems worldwide. The aim of this study was to estimate the health-economic burden of reimbursement payment in Europe for PJIs following primary hip and knee arthroplasty. Methods: The calculation was based on health-economic modelling using data on primary hip and knee arthroplasties for the year 2019 from the Statistical Office of the European Union (Eurostat) and published infection rates to estimate the total number of hip and knee PJIs in 30 European countries. Revision procedures were stratified into: 1) debridement, antibiotics, and implant retention (DAIR); 2) one-stage exchange; and 3) two-stage revision procedures. The cases were then multiplied by the respective healthcare system reimbursement payments. Payment data were acquired from a survey of 13 countries (Austria, Croatia, France, Germany, Italy, Lithuania, Netherlands, Norway, Portugal, Slovenia, Switzerland, Turkey, and the UK) and extrapolated for the remaining countries. Results: In 2019, a total of 2,048,778 primary total joint replacements were performed (total hip arthroplasty (THA) = 1,147,316 and total knee arthroplasty (TKA) = 901,462), with an estimated 20,416 cases of PJIs (11,131 hip and 9,285 knee) in Europe. This results in an estimated total reimbursement burden of €346,262,026 for European healthcare systems. The breakdown for hip PJI reimbursement was €197,230,953 (€9,751,962 for DAIR procedures, €45,135,894 for one-stage revisions, and €142,343,097 for two-stage revisions). For knee PJIs, the analysis yielded a total reimbursement of €149,031,073 (€9,335,075 for DAIR procedures, €48,058,479 for one-stage revisions, and €91,637,518 for two-stage revisions). Conclusion: This is the first study to evaluate the health-economic burden of PJIs in Europe, revealing a substantial impact on healthcare systems with an estimated case load of 20,414 cases and overall reimbursement of €346,262,026 for primary THAs and TKAs performed in 2019. Cite this article: Bone Jt Open 2025;6(3):298–311. |
| format | Article |
| id | doaj-art-722ef1ec2dbf4431bd4e009b7cc122c8 |
| institution | OA Journals |
| issn | 2633-1462 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj-art-722ef1ec2dbf4431bd4e009b7cc122c82025-08-20T02:11:11ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622025-03-016329831110.1302/2633-1462.63.BJO-2024-0225.R1The health-economic burden of hip and knee periprosthetic joint infections in Europe: a comprehensive analysis following primary arthroplastyVolker Alt0https://orcid.org/0000-0003-0208-4650Dominik Szymski1https://orcid.org/0000-0002-1739-8524Markus Rupp2https://orcid.org/0000-0001-7221-3783Andreas Fontalis3https://orcid.org/0000-0001-5547-288XDanguole Vaznaisiene4https://orcid.org/0000-0001-9114-9537Leonard C. Marais5https://orcid.org/0000-0002-1120-8419Christof Wagner6Nike Walter7https://orcid.org/0000-0002-0654-2076on behalf the Country Delegates of the European Bone and Joint Infection Society*Department of Trauma Surgery, University Hospital Regensburg, Regensburg, GermanyDepartment of Trauma Surgery, University Hospital Regensburg, Regensburg, GermanyDepartment of Trauma Surgery, University Hospital Regensburg, Regensburg, GermanyDivision of Surgery & Interventional Science, University College London, London, UKDepartment of Infectious Diseases, Lithuanian University of Health Sciences, Kaunas, LithuaniaOrthopaedic Surgery, University of KwaZulu-Natal Nelson R Mandela School of Medicine, Durban, South AfricaCenter for Orthopaedic and Trauma Surgery, Klinikum Ingolstadt GmbH, Ingolstadt, GermanyDepartment of Trauma Surgery, University Hospital Regensburg, Regensburg, GermanyAims: Periprosthetic joint infections (PJIs) pose significant challenges to patients and healthcare systems worldwide. The aim of this study was to estimate the health-economic burden of reimbursement payment in Europe for PJIs following primary hip and knee arthroplasty. Methods: The calculation was based on health-economic modelling using data on primary hip and knee arthroplasties for the year 2019 from the Statistical Office of the European Union (Eurostat) and published infection rates to estimate the total number of hip and knee PJIs in 30 European countries. Revision procedures were stratified into: 1) debridement, antibiotics, and implant retention (DAIR); 2) one-stage exchange; and 3) two-stage revision procedures. The cases were then multiplied by the respective healthcare system reimbursement payments. Payment data were acquired from a survey of 13 countries (Austria, Croatia, France, Germany, Italy, Lithuania, Netherlands, Norway, Portugal, Slovenia, Switzerland, Turkey, and the UK) and extrapolated for the remaining countries. Results: In 2019, a total of 2,048,778 primary total joint replacements were performed (total hip arthroplasty (THA) = 1,147,316 and total knee arthroplasty (TKA) = 901,462), with an estimated 20,416 cases of PJIs (11,131 hip and 9,285 knee) in Europe. This results in an estimated total reimbursement burden of €346,262,026 for European healthcare systems. The breakdown for hip PJI reimbursement was €197,230,953 (€9,751,962 for DAIR procedures, €45,135,894 for one-stage revisions, and €142,343,097 for two-stage revisions). For knee PJIs, the analysis yielded a total reimbursement of €149,031,073 (€9,335,075 for DAIR procedures, €48,058,479 for one-stage revisions, and €91,637,518 for two-stage revisions). Conclusion: This is the first study to evaluate the health-economic burden of PJIs in Europe, revealing a substantial impact on healthcare systems with an estimated case load of 20,414 cases and overall reimbursement of €346,262,026 for primary THAs and TKAs performed in 2019. Cite this article: Bone Jt Open 2025;6(3):298–311.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.63.BJO-2024-0225.R1periprosthetic joint infectionhealth economicshipkneearthroplastyreimbursementhipknee periprosthetic joint infectionsperiprosthetic joint infection (pji)kneedebridement, antibiotics, and implant retentiontotal knee arthroplasty (tka)hip and knee arthroplastieship and knee arthroplastiesprimary total hip arthroplastiesinfections |
| spellingShingle | Volker Alt Dominik Szymski Markus Rupp Andreas Fontalis Danguole Vaznaisiene Leonard C. Marais Christof Wagner Nike Walter on behalf the Country Delegates of the European Bone and Joint Infection Society* The health-economic burden of hip and knee periprosthetic joint infections in Europe: a comprehensive analysis following primary arthroplasty Bone & Joint Open periprosthetic joint infection health economics hip knee arthroplasty reimbursement hip knee periprosthetic joint infections periprosthetic joint infection (pji) knee debridement, antibiotics, and implant retention total knee arthroplasty (tka) hip and knee arthroplasties hip and knee arthroplasties primary total hip arthroplasties infections |
| title | The health-economic burden of hip and knee periprosthetic joint infections in Europe: a comprehensive analysis following primary arthroplasty |
| title_full | The health-economic burden of hip and knee periprosthetic joint infections in Europe: a comprehensive analysis following primary arthroplasty |
| title_fullStr | The health-economic burden of hip and knee periprosthetic joint infections in Europe: a comprehensive analysis following primary arthroplasty |
| title_full_unstemmed | The health-economic burden of hip and knee periprosthetic joint infections in Europe: a comprehensive analysis following primary arthroplasty |
| title_short | The health-economic burden of hip and knee periprosthetic joint infections in Europe: a comprehensive analysis following primary arthroplasty |
| title_sort | health economic burden of hip and knee periprosthetic joint infections in europe a comprehensive analysis following primary arthroplasty |
| topic | periprosthetic joint infection health economics hip knee arthroplasty reimbursement hip knee periprosthetic joint infections periprosthetic joint infection (pji) knee debridement, antibiotics, and implant retention total knee arthroplasty (tka) hip and knee arthroplasties hip and knee arthroplasties primary total hip arthroplasties infections |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.63.BJO-2024-0225.R1 |
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