Haddad F S, Ngu A, Negus J J
University College London Hospitals, Euston road, London, NW1 2BU, UK.
Adv Exp Med Biol. 2017;971:93-100. doi: 10.1007/5584_2016_155.
Prosthetic joint infection is a devastating complication of arthroplasty surgery that can lead to debilitating morbidity for the patient and significant expense for the healthcare system. With the continual rise of arthroplasty cases worldwide every year, the revision load for infection is becoming a greater financial burden on healthcare budgets. Prevention of infection has to be the key to reducing this burden. For treatment, it is critical for us to collect quality data that can guide future management strategies to minimise healthcare costs and morbidity / mortality for patients. There has been a management shift in many countries to a less expensive 1-stage strategy and in selective cases to the use of debridement, antibiotics and implant retention. These appear very attractive options on many levels, not least cost. However, with a consensus on the definition of joint infection only clarified in 2011, there is still the need for high quality cost analysis data to be collected on how the use of these different methods could impact the healthcare expenditure of countries around the world. With a projected spend on revision for infection at US$1.62 billion in the US alone, this data is vital and urgently needed.
人工关节感染是关节置换手术的一种毁灭性并发症，会给患者带来使人衰弱的发病率，并给医疗系统造成巨大费用。随着全球每年关节置换病例的持续增加，因感染进行翻修手术的负担正给医疗预算带来更大的经济压力。预防感染必须是减轻这一负担的关键。对于治疗而言，对我们来说至关重要的是收集高质量数据，这些数据能够指导未来的管理策略，以尽量降低医疗成本以及患者的发病率/死亡率。许多国家已将管理方式转向成本较低的一期策略，在某些特定情况下则采用清创、抗生素和保留植入物的方法。这些方法在很多层面上看起来都很有吸引力，尤其是在成本方面。然而，直到2011年才对关节感染的定义达成共识，因此仍需要收集高质量的成本分析数据，以了解使用这些不同方法会如何影响世界各国的医疗支出。仅在美国，预计因感染进行翻修手术的花费就达16.2亿美元，这些数据至关重要且迫切需要。
