High-Volume Hospitals Are Associated With Lower Rates of Mortality Following Revision Arthroplasty for Periprosthetic Joint Infection.

Julian Wier, McKenzie W Culler, Avinash Iyer, Ryan Palmer, Sagar Telang, Jay R Lieberman, Nathanael D Heckmann

Abstract read

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Article in Arthroplasty today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Julian WierDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

McKenzie W CullerDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Avinash IyerDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Ryan PalmerDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Sagar TelangDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Jay R LiebermanDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Nathanael D HeckmannDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The relationship between hospital case volume and postoperative morbidity following revision arthroplasty for periprosthetic joint infection (PJI) has not been defined. As such, we sought to compare 90-day postoperative mortality rates among patients undergoing antibiotic spacer placement for PJI of the hip or knee between high- vs low-volume hospitals. Materials and methods: The Premier Healthcare Database was queried from 2016 to 2023 for adult patients undergoing antibiotic spacer placement for PJI. Using the Metropolis-Hastings algorithm, a single hospital volume threshold, below which mortality increased, was identified. Patients were divided by those operated on by high- vs low-volume hospitals. Multivariable logistic regression was conducted to assess odds of 90-day mortality and sepsis. Results: In a cohort of 55,670 PJIs, postoperative mortality was decreased in patients who were operated on by hospitals performing ≥35 antibiotic spacers annually (high volume). The adjusted odds of mortality (adjusted odds ratio = 0.76; 95% confidence interval = 0.65-0.88, Conclusions: Patients receiving PJI care at hospitals performing greater than 35 antibiotic spacers annually died less frequently and had improved outcomes than those presenting to lower volume centers. These findings reinforce emerging evidence in support of centralized PJI care centers to improve patient survival.

Identifiers

PMID42621178

DOI10.1016/j.artd.2026.102111

PMCPMC13487019

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