Evidence map›Paper›PMID 42635825›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026

Epidemiology and healthcare burden of implant-associated complications in Germany: a nationwide population-based analysis.

Houmam Anees, Christian Heiss, Thaqif El Khassawna

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 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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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Houmam AneesDepartment of Trauma, Hand and Reconstructive Surgery, Faculty of Medicine, Justus-Liebig-University of Giessen, 35392, Giessen, Germany. Houmam.Anees@chiru.med.uni-giessen.de.ORCID http://orcid.org/0009-0002-2427-0841
Christian HeissDepartment of Trauma, Hand and Reconstructive Surgery, Faculty of Medicine, Justus-Liebig-University of Giessen, 35392, Giessen, Germany.ORCID http://orcid.org/0000-0002-9593-162X
Thaqif El KhassawnaExperimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University of Giessen, 35392, Giessen, Germany.ORCID http://orcid.org/0000-0002-1187-8578

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeImplant-associated complications remain a major challenge in orthopaedic and trauma surgery, particularly among elderly patients requiring revision procedures or infection management. This study analysed nationwide trends and healthcare burden of implant-associated complications in Germany.

methodsNationwide German hospital discharge data from 2000 to 2023 were analysed and complemented by Diagnosis-Related Group (DRG) data from 2024. Cases were identified using ICD-10-GM code T84 and its subcategories. Outcomes included temporal trends, age-standardised incidence, demographic characteristics, in-hospital mortality, length of stay (LOS), and DRG-based healthcare resource utilisation.

resultsHospitalisations for implant-associated complications increased from 45,121 in 2000 to a peak of 95,154 in 2011, followed by a decline to 72,846 in 2023. Age-standardised incidence decreased by approximately 31% between 2010 and 2023. Segmented regression identified a temporal breakpoint in 2010.6, with annual percentage changes of + 6.21% before and - 3.55% after the breakpoint. Annual hospitalisations for periprosthetic joint infection increased from 5,367 to 11,215, while osteosynthesis-associated infections increased from 2,469 to 7,059. Mean LOS decreased from 20.8 to 11.8 days, whereas in-hospital mortality remained stable. Compared with low-complexity cases, infection-related complications were associated with prolonged hospitalisation and approximately threefold higher treatment costs, while complex revision procedures generated mean costs exceeding €9,000 per case.

conclusionAlthough the age-standardised incidence of implant-associated complications has declined in recent years, infection-related complications and complex revision procedures continue to impose a substantial clinical and economic burden, underlining the need for continued optimisation of prevention and treatment strategies.

Indexed as

Postoperative ComplicationsProsthesis-Related InfectionsAdultAgedAged, 80 and overFemaleGermanyHospitalizationHospital MortalityHumansIncidenceLength of StayMaleMiddle AgedReoperationDiagnosis-related groupsHealthcare costsImplant-associated complicationsPeriprosthetic joint infectionRevision surgeryTrauma surgery

Identifiers

PMID42635825
PMCPMC13503490

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.