SynthesisBMC musculoskeletal disorders2021
Cost of septic and aseptic revision total knee arthroplasty: a systematic review.
Synthesis in BMC musculoskeletal disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Aspirin Versus LMWH for Thromboprophylaxis Following Hip or Knee Arthroplasty-Clinical Implications and Budget Impact.Pharmacology research & perspectives · 2025Pooled it
- Pooled it
- Does Aspiration With Culture Augmented With Percutaneous Core Biopsy Analysis Have Better Diagnostic Value Than Culture Alone for PJI in Large Joints? A Prospective Enhancement and Feasibility Study.Clinical orthopaedics and related research · 2026Article
- Multiscale Interface Engineering for Orthopedic and Dental Implants: A Review.Journal of functional biomaterials · 2026Review
- Patient-reported outcomes and component rotation in total knee replacement: a prospective, observational study in 498 patients.BMJ open · 2026Observational
- Machine Learning-Driven Probability Scoring Enhances Diagnostic Certainty and Reduces Costs in Suspected Periprosthetic Joint Infection.Diagnostics (Basel, Switzerland) · 2026Article
- Mid-term performance of a unicompartmental knee prosthesis.Journal of experimental orthopaedics · 2026Article
- No difference in 5-year survivorship between cemented versus cementless total knee arthroplasty in a cohort of 5266 patients using a deep-dish mobile bearing implant.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- One-Stage Primary Total Knee Arthroplasty as the Treatment of Acute Septic Arthritis of the Native Osteoarthritic Knee: Report of 3 Cases and Review of Literature.Arthroplasty today · 2025Article
- Editorial: Challenges and advances in revision total joint arthroplasty.Arthroplasty (London, England) · 2025Article
- Big data analysis reveals significant increases in complications, costs, and hospital stay in revision total knee arthroplasty compared to primary TKA.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Trends and Themes in the Study of Value in Orthopedic Surgery: A Systematic Review.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2025Review
- Incidence rate of total knee arthroplasties in eleven European countries: Do they reach a plateau?PloS one · 2025Article
- Diagnosis and Treatment of Acute Periprosthetic Infections with the BioFireBiomedicines · 2024Review
- Article
- The Impact of Culture Negativity on the Outcomes of Revision Total Knee Arthroplasty for Chronic PJI.Microorganisms · 2024Article
- Clinical applications of metagenomic next-generation sequencing in the identification of pathogens in periprosthetic joint infections: a retrospective study.Journal of orthopaedic surgery and research · 2024Article
- Periprosthetic Joint Infection After Total Knee Arthroplasty With or Without Antibiotic Bone Cement.JAMA network open · 2024Article
- Article
- Revision total knee replacement finances: a detailed cost-analysis of operative practice at a regional tertiary referral centre.BMC health services research · 2024Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe increasing incidence of primary total knee arthroplasty (TKA) has led to an increase in both the incidence and the cost burden of revision TKA procedures. This study aimed to review the literature on the cost of revision TKA for septic and aseptic causes and to identify the major cost components contributing to the cost burden.
methodsWe searched MEDLINE (OvidSp), Embase, Web of Science, Cochrane Library, EconLit, and Google Scholar to identify relevant studies. Selection, data extraction and assessment of the risk of bias and cost transparency within the studies were conducted by two independent reviewers, after which the cost data were analysed narratively for 1- or 2-stage septic revision without re-revision; 2-stage septic revision with re-revision; and aseptic revision with and without re-revision, respectively. The major cost components identified in the respective studies were also reported.
resultsThe direct medical cost from the healthcare provider perspective for high-income countries for 2-stage septic revision with re-revision ranged from US$66,629 to US$81,938, which can be about 2.5 times the cost of 1- or 2-stage septic revision without re-revision, (range: US$24,027 - US$38,109), which can be about double the cost of aseptic revision without re-revision (range: US$13,910 - US$29,213). The major cost components were the perioperative cost (33%), prosthesis cost (28%), and hospital ward stay cost (22%).
conclusionsSeptic TKA revision with re-revision for periprosthetic joint infection (PJI) increases the cost burden of revision TKA by 4 times when compared to aseptic single-stage revision and by 2.5 times when compared to septic TKA revision that does not undergo re-revision. Cost reductions can be achieved by reducing the number of primary TKA that develop PJI, avoidance of re-revisions for PJI, and reduction in the length of stay after revision.
trial registrationPROSPERO; CRD42020171988 .
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Registered trials
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