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Septic knee revision more expensive, linked with longer stay vs. aseptic revision


August 10, 2022

1 min read



Villa JM, et al. Paper 989. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 5-6, 2022; Pittsburgh (hybrid meeting).

Villa reports no relevant financial disclosures.

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Results showed septic knee revisions, specifically explantations, were more expensive and had longer length of stay vs. aseptic revisions. Single-stage reimplantation had the best societal value for periprosthetic joint infection treatment.

“Adjusting the codes is needed because everybody knows that these cases are expensive, and nobody wants to do them and this is limiting the access to care of patients,” Jesus M. Villa, MD, said in his presentation at the Musculoskeletal Infection Society Annual Meeting.

Knee infection

Source: Adobe Stock

Villa and colleagues retrospectively categorized 512 patients who underwent 653 unilateral total knee revisions based on whether they received an aseptic revision, irrigation and debridement for periprosthetic joint infection with insert exchange, explantation with or without a spacer, spacer-exchange, second-stage reimplantation or single-stage reimplantation. Researchers collected professional and technical charges and compared the total charges between patients who underwent aseptic revision with those who underwent septic revision.

“Overall, the difference between septic and aseptic in terms of demographics [was that] there were significantly more males in septic revisions and there was a higher proportion of [American Society of Anesthesiologists] 3 cases in the septic cases,” Villa said.

Villa noted patients who underwent aseptic revision had a length of stay of 2.3 days, while patients who underwent explantation had a length of stay of 8 days. However, length of stay was not different between the aseptic revision group and the second-stage reimplantation group, according to Villa.

He added professional charges for explanations were almost 100% higher compared with those for patients who underwent average aseptic revision.

“The overall charges for [the explantation] group was 57%,” Villa said. “The other group that exhibited differences was the reimplantation at the second stage in terms of the technical and hospital charges.”

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