Analysis of the economic and clinical effectiveness of one- and two-stage revisions in the treatment of periprosthetic infection of the hip joint (literature review)
Introduction Infection is a devastating complication of joint replacement surgery and is associated with significant medical costs of treatment and rehabilitation. This review is based on the analysis of modern domestic and foreign literature and demonstrates the problem of periprosthetic joint in...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2022-12-01
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| Series: | Гений oртопедии |
| Subjects: |
| _version_ | 1811294617443762176 |
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| author | Nikita I. Rozhkov Artem M. Ermakov Alexander V. Burtsev Aleksandr S. Triapichnikov Natalia V. Sazonova Leonid I. Malychenko |
| author_facet | Nikita I. Rozhkov Artem M. Ermakov Alexander V. Burtsev Aleksandr S. Triapichnikov Natalia V. Sazonova Leonid I. Malychenko |
| author_sort | Nikita I. Rozhkov |
| collection | DOAJ |
| description | Introduction Infection is a devastating complication of joint replacement surgery and is associated with significant medical costs of treatment
and rehabilitation. This review is based on the analysis of modern domestic and foreign literature and demonstrates the problem of periprosthetic
joint infection (PJI) in terms of etiology, pathogenesis, diagnosis and surgical treatment options for PJI, as well as economic costs in different
countries. Currently, two-stage revision arthroplasty is the most used treatment method in the world. At the same time, the number of publications
on the effectiveness of one-stage revision arthroplasty in PJI has been increasing every year. Purpose Analysis of the clinical and economic
efficiency of one- and two-stage revision arthroplasty interventions for suppression of the purulent inflammatory process and their medical costs
Materials and methods The literature search was carried out in open electronic databases of scientific literature PubMed, eLIBRARY and Scopus.
The search depth was 22 years. Sixteen articles were selected for economic analysis in which the expenditures on PJI management in developed and
developing countries were reported. Also, there were 15 studies on evaluating the effectiveness of two-stage revisions and 26 articles on evaluating
the effectiveness of one-stage revisions and 15 articles on analyzing the functional state of the affected limb according to the Harris Hip Score. The
following inclusion criteria were used: systematic reviews, literature reviews, cohort studies on the topic of periprosthetic infection. Results The rate of
PJI arrest with one-stage method was 89.5 % (Me-88.6; Q1-86 Q3-94) and the average mortality was 2.23 ± 2.24 (Me-1.2 Q1-0.8 Q3 -2.7). The rate of
PJI suppression by two-stage method averaged 91.4 % (Me-93;Q1-88.2 Q3-96) with an average mortality rate of 3.2 %. The functional HHS after onestage
replacement averaged 81.8 points, and after two-stage revision arthroplasty it was 77.4 points. The economic cost of treating one patient with PJI,
according to various authors, varies from 6,500 to 150,000 dollars. Conclusions One-stage revision is cost-effective, has better functional parameters
and lower mortality with comparable results in PJI arrest if strict adherence to indications is followed. |
| first_indexed | 2024-04-13T05:20:06Z |
| format | Article |
| id | doaj.art-48ede7a41a5840239cf64ad3e70c06e7 |
| institution | Directory Open Access Journal |
| issn | 1028-4427 2542-131X |
| language | English |
| last_indexed | 2024-04-13T05:20:06Z |
| publishDate | 2022-12-01 |
| publisher | Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics |
| record_format | Article |
| series | Гений oртопедии |
| spelling | doaj.art-48ede7a41a5840239cf64ad3e70c06e72022-12-22T03:00:46ZengRussian Ilizarov Scientific Center for Restorative Traumatology and OrthopaedicsГений oртопедии1028-44272542-131X2022-12-0128684285110.18019/1028-4427-2022-28-6-842-851Analysis of the economic and clinical effectiveness of one- and two-stage revisions in the treatment of periprosthetic infection of the hip joint (literature review)Nikita I. Rozhkov0https://orcid.org/0000-0003-1848-9839Artem M. Ermakov1https://orcid.org/0000-0002-5420-4637Alexander V. Burtsev2https://orcid.org/0000-0001-8968-6528Aleksandr S. Triapichnikov3https://orcid.org/0000-0001-7305-506XNatalia V. Sazonova4Leonid I. Malychenko5https://orcid.org/0000-0003-4199-7954Ilizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian FederationIlizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian FederationIlizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian FederationIlizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian FederationIlizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian FederationIlizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian FederationIntroduction Infection is a devastating complication of joint replacement surgery and is associated with significant medical costs of treatment and rehabilitation. This review is based on the analysis of modern domestic and foreign literature and demonstrates the problem of periprosthetic joint infection (PJI) in terms of etiology, pathogenesis, diagnosis and surgical treatment options for PJI, as well as economic costs in different countries. Currently, two-stage revision arthroplasty is the most used treatment method in the world. At the same time, the number of publications on the effectiveness of one-stage revision arthroplasty in PJI has been increasing every year. Purpose Analysis of the clinical and economic efficiency of one- and two-stage revision arthroplasty interventions for suppression of the purulent inflammatory process and their medical costs Materials and methods The literature search was carried out in open electronic databases of scientific literature PubMed, eLIBRARY and Scopus. The search depth was 22 years. Sixteen articles were selected for economic analysis in which the expenditures on PJI management in developed and developing countries were reported. Also, there were 15 studies on evaluating the effectiveness of two-stage revisions and 26 articles on evaluating the effectiveness of one-stage revisions and 15 articles on analyzing the functional state of the affected limb according to the Harris Hip Score. The following inclusion criteria were used: systematic reviews, literature reviews, cohort studies on the topic of periprosthetic infection. Results The rate of PJI arrest with one-stage method was 89.5 % (Me-88.6; Q1-86 Q3-94) and the average mortality was 2.23 ± 2.24 (Me-1.2 Q1-0.8 Q3 -2.7). The rate of PJI suppression by two-stage method averaged 91.4 % (Me-93;Q1-88.2 Q3-96) with an average mortality rate of 3.2 %. The functional HHS after onestage replacement averaged 81.8 points, and after two-stage revision arthroplasty it was 77.4 points. The economic cost of treating one patient with PJI, according to various authors, varies from 6,500 to 150,000 dollars. Conclusions One-stage revision is cost-effective, has better functional parameters and lower mortality with comparable results in PJI arrest if strict adherence to indications is followed.periprosthetic infectionone-stage revisiontwo-stage revisionarthroplastyhip jointeconomic costs |
| spellingShingle | Nikita I. Rozhkov Artem M. Ermakov Alexander V. Burtsev Aleksandr S. Triapichnikov Natalia V. Sazonova Leonid I. Malychenko Analysis of the economic and clinical effectiveness of one- and two-stage revisions in the treatment of periprosthetic infection of the hip joint (literature review) Гений oртопедии periprosthetic infection one-stage revision two-stage revision arthroplasty hip joint economic costs |
| title | Analysis of the economic and clinical effectiveness of one- and two-stage revisions in the treatment of periprosthetic infection of the hip joint (literature review) |
| title_full | Analysis of the economic and clinical effectiveness of one- and two-stage revisions in the treatment of periprosthetic infection of the hip joint (literature review) |
| title_fullStr | Analysis of the economic and clinical effectiveness of one- and two-stage revisions in the treatment of periprosthetic infection of the hip joint (literature review) |
| title_full_unstemmed | Analysis of the economic and clinical effectiveness of one- and two-stage revisions in the treatment of periprosthetic infection of the hip joint (literature review) |
| title_short | Analysis of the economic and clinical effectiveness of one- and two-stage revisions in the treatment of periprosthetic infection of the hip joint (literature review) |
| title_sort | analysis of the economic and clinical effectiveness of one and two stage revisions in the treatment of periprosthetic infection of the hip joint literature review |
| topic | periprosthetic infection one-stage revision two-stage revision arthroplasty hip joint economic costs |
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