This retrospective epidemiological study used the Nationwide Inpatient Sample (1990–2004) to quantify national infection burden, resource utilization, and institutional distribution of periprosthetic joint infection after hip and knee arthroplasty. It asks: how common is infection at a national level, who bears the burden, and what does it cost?
When a patient asks about infection risk before their joint replacement, quote these national benchmarks: roughly 1% infection burden for both THA and TKA. That number comes from 15 years of nationwide data, not a single-center series.
When infection does occur, the resource impact is severe. Infected THA cases run 2.21× longer stays and 1.76× higher charges. These figures anchor the cost-effectiveness arguments for infection prevention measures like preoperative optimization and antibiotic prophylaxis.
Critical distinction for boards and rounds: this study measures infection burden (proportion of arthroplasty hospitalizations flagged for infection), not true per-patient infection risk. The NIS cannot track individuals longitudinally. Urban non-teaching hospitals' higher rates reflect referral of revision cases, not worse surgical quality.
The ~5% annual rise in infection odds, set against projected dramatic growth in arthroplasty volume, is why periprosthetic joint infection prevention remains one of the highest-priority research areas in reconstruction.
This retrospective epidemiological study used the Nationwide Inpatient Sample (1990–2004) to quantify national infection burden, resource utilization, and institutional distribution of periprosthetic joint infection after hip and knee arthroplasty. It asks: how common is infection at a national level, who bears the burden, and what does it cost?
When a patient asks about infection risk before their joint replacement, quote these national benchmarks: roughly 1% infection burden for both THA and TKA. That number comes from 15 years of nationwide data, not a single-center series.
When infection does occur, the resource impact is severe. Infected THA cases run 2.21× longer stays and 1.76× higher charges. These figures anchor the cost-effectiveness arguments for infection prevention measures like preoperative optimization and antibiotic prophylaxis.
Critical distinction for boards and rounds: this study measures infection burden (proportion of arthroplasty hospitalizations flagged for infection), not true per-patient infection risk. The NIS cannot track individuals longitudinally. Urban non-teaching hospitals' higher rates reflect referral of revision cases, not worse surgical quality.
The ~5% annual rise in infection odds, set against projected dramatic growth in arthroplasty volume, is why periprosthetic joint infection prevention remains one of the highest-priority research areas in reconstruction.