Burden of Revision Total Knee Arthroplasty Following Periprosthetic Joint Infection Based on the Korean National Registry between 2011 and 2019.

Background: This study aimed to document the epidemiology of revision total knee arthroplasty following periprosthetic joint infection (RTKA-f-PJI) in Korea between 2011 and 2019 and analyze the economic burden of RTKA-f-PJI.

Methods: Epidemiological data on RTKA-f-PJI in Korea between 2011 and 2019 were obtained from the Korean Health Insurance Review and Assessment database. The annual numbers and growth rates of entire RTKAs and RTKA-f-PJIs and the RTKA-f-PJI rate (RTKA-f-PJI / entire RTKAs) were determined. Subgroup analyses were performed according to sex and age. TKA failure was categorized into early and late failures, and RTKA-f-PJI rates were compared between the groups. The total and mean personal costs for each year were compared between the RTKA-f-PJI and RTKA-f-non-PJI groups.

Results: Between 2011 and 2019, the total growth rate of RTKA-f-PJI was 57.6%, and the RTKA-f-PJI rate was maintained at approximately 30%. The RTKA-f-PJI rate was higher in males than in females. The number of RTKA-f-PJIs markedly increased in patients aged 70-79 years and ≥ 80 years. The RTKA-f-PJI rates for early and late failures were 45% and 24.8%, respectively. The total cost of RTKA-f-PJI increased from $15,757,308 in 2011 to $19,606,594 in 2019. The mean personal cost of RTKA-f-PJI was more than 4 times higher than that of RTKA-f-non-PJI.

Conclusions: The number and socioeconomic costs of RTKA-f-PJIs increased significantly in Korea between 2011 and 2019. Given that RTKA-f-PJI is a complex procedure associated with higher complication rates and unsatisfactory functional outcomes, continuous efforts to reduce the incidence of PJI after TKA are necessary.