Abstract
Several fields of orthopedics have concluded benefits from volume thresholds. We postulate that we could similarly optimize periprosthetic joint infection (PJI) treatment by creating a regional referral center, concentrating expertise and resources. Here, we review our reasoning and our first-year experience of a PJI referral center in the United States.
Highlights
While there is precedence of improved outcomes in complex orthopedic care at US specialty centers, in areas such as spine metastasis and sarcoma care, none exist for the treatment of periprosthetic joint infection (PJI) (Lazarides et al, 2019; Malik et al, 2021)
Similar to the French experience, we expect to show the same increase in value by concentrating the care of PJI. We expect this will significantly improve the economics of PJI treatment
We have shown that the establishment of a PJI center is feasible and well accepted by patients who are willing to travel for specialized care
Summary
This concept is not new in Europe. Recognizing the potential clinical and economic value of tertiary centers devoted to bone and joint infections, the French Health Ministry established a national network of 24 centers. While there is precedence of improved outcomes in complex orthopedic care at US specialty centers, in areas such as spine metastasis and sarcoma care, none exist for the treatment of periprosthetic joint infection (PJI) (Lazarides et al, 2019; Malik et al, 2021). As well established in sarcoma care, PJI surgical treatment initiated prior to referral to a tertiary center leads to worse 2-year infection-free survival (Tetreault et al, 2017). A PJI referral center could improve the success rate of PJI treatment by concentrating resources and expertise, and limiting the current care fragmentation.
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