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Cost Drivers in Two-Stage Treatment of Hip Periprosthetic Joint Infection With an Antibiotic Coated Cement Hip Spacer.

Publication ,  Journal Article
Charalambous, LT; Wixted, CM; Kim, BI; Cochrane, NH; Belay, ES; Joseph, HL; Seyler, TM
Published in: J Arthroplasty
January 2023

BACKGROUND: The current gold standard for treating chronic Periprosthetic Joint Infection (PJI) is a 2-stage revision arthroplasty. There has been little investigation into what specific patient and operative factors may be able to predict higher costs of this treatment. METHODS: An institutional electronic health record database was retrospectively queried for patients who developed a PJI after a total hip arthroplasty, and underwent removal of the prosthesis and implantation of an antibiotic-impregnated articulating hip cement spacer. Patient demographics, surgical variables, hospital readmissions, emergency department visits, and post-operative complications were collected. Total costs were captured through an internal accounting database through 2 years post-operatively. Negative binomial regressions were utilized for multivariable analyses. A total of 55 hips with PJI were available for cost analyses. RESULTS: A comorbidity index score was associated with a 70% increase (Odds Ratio (OR): 1.7 [1.18-2.5], P = .003) in total costs at 2-years. Illicit drug use was associated with a 70% increase in costs at 1-year post-operatively (OR 1.7 [1.18-2.5], P = .003). Metal-on-poly liners were associated with a 22% decrease in cost at 2-years post-operatively when compared to Cement-on-Bone articulating spacers, and Metal-on-poly -constrained liners accounted for 38% lower costs at 1-year (OR 0.62 [0.44-0.87], P = .004). Use of an intraoperative extended trochanteric osteotomy was associated with a 46 and 61% increase in cost at 1-year (OR 1.46 [1.14-1.89]) and 2-years (OR 1.61 [1.26-2.07], P < .001) post-operatively. CONCLUSION: Age, comorbidity index score, drug use, and extended trochanteric osteotomy were associated with increased costs of PJI treatment. This may be used to improve reimbursement models and target areas of cost savings.

Duke Scholars

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

January 2023

Volume

38

Issue

1

Start / End Page

6 / 12

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Reoperation
  • Prosthesis-Related Infections
  • Orthopedics
  • Humans
  • Arthroplasty, Replacement, Hip
  • Arthritis, Infectious
  • Anti-Bacterial Agents
  • 4003 Biomedical engineering
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Charalambous, L. T., Wixted, C. M., Kim, B. I., Cochrane, N. H., Belay, E. S., Joseph, H. L., & Seyler, T. M. (2023). Cost Drivers in Two-Stage Treatment of Hip Periprosthetic Joint Infection With an Antibiotic Coated Cement Hip Spacer. J Arthroplasty, 38(1), 6–12. https://doi.org/10.1016/j.arth.2022.07.011
Charalambous, Lefko T., Colleen M. Wixted, Billy I. Kim, Niall H. Cochrane, Elshaday S. Belay, Hayden L. Joseph, and Thorsten M. Seyler. “Cost Drivers in Two-Stage Treatment of Hip Periprosthetic Joint Infection With an Antibiotic Coated Cement Hip Spacer.J Arthroplasty 38, no. 1 (January 2023): 6–12. https://doi.org/10.1016/j.arth.2022.07.011.
Charalambous LT, Wixted CM, Kim BI, Cochrane NH, Belay ES, Joseph HL, et al. Cost Drivers in Two-Stage Treatment of Hip Periprosthetic Joint Infection With an Antibiotic Coated Cement Hip Spacer. J Arthroplasty. 2023 Jan;38(1):6–12.
Charalambous, Lefko T., et al. “Cost Drivers in Two-Stage Treatment of Hip Periprosthetic Joint Infection With an Antibiotic Coated Cement Hip Spacer.J Arthroplasty, vol. 38, no. 1, Jan. 2023, pp. 6–12. Pubmed, doi:10.1016/j.arth.2022.07.011.
Charalambous LT, Wixted CM, Kim BI, Cochrane NH, Belay ES, Joseph HL, Seyler TM. Cost Drivers in Two-Stage Treatment of Hip Periprosthetic Joint Infection With an Antibiotic Coated Cement Hip Spacer. J Arthroplasty. 2023 Jan;38(1):6–12.
Journal cover image

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

January 2023

Volume

38

Issue

1

Start / End Page

6 / 12

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Reoperation
  • Prosthesis-Related Infections
  • Orthopedics
  • Humans
  • Arthroplasty, Replacement, Hip
  • Arthritis, Infectious
  • Anti-Bacterial Agents
  • 4003 Biomedical engineering