These authors suggest that in North America, two-stage reimplantation is the most common treatment strategy used for the infected shoulder arthroplasty. They sought to determine the cost of two-stage reimplantation for deep infection after shoulder arthroplasty 57 shoulders having this procedure between 2003 and 2012.
Implants placed at reimplantation included anatomic total shoulder arthroplasty (a-TSA) in 58%, reverse total shoulder arthroplasty (r-TSA) in 40%, and hemiarthroplasty (HA) in 2%. The costs of the two stage procedure were compared to those of 2953 primary shoulder arthroplasties (a-TSA in 55%, r-TSA in 28%, and HA in 17%).
The mean hospital cost per shoulder for two-stage reimplantation was $35,824, significantly higher than for primary procedures $16,068.
For part A (hospital services), the mean cost for two-stage reimplantation was $29,85, compared to $13,508 for primaries.
For part B (professional costs), mean costs were $5973 versus 2560 (95% CI: 2512 to 2608) respectively.
Data on the (1) organisms treated with the two stage procedure, (2) the success of the procedure in eliminating the infection, and (3) the comfort and function of shoulders having a two stage reimplantation are not provided.
Comment: This article documents that the two procedures that comprise a two-stage reimplantation for infection are just over twice as costly as a single stage primary. This analysis does not include the facts that (1) the risks and complications of two-stage reimplantation are also higher and (2) patients may choose not to have or may expire before the second stage.
For this reason, for most cases of infection we consider a single stage exchange as explained in this link and as demonstrated in this link. The cost for a single stage procedure is not substantially different from a primary arthroplasty. The advantages of the single stage include avoiding the risks, complications and costs of a second procedure. A two stage revision is considered for recurrent periprosthetic infections, infections with particularly virulent organisms, infections in patients with immunologic compromise, and those with draining sinuses.
Consultation for those who live a distance away from Seattle.
Click here to see the new Shoulder Arthritis Book.
Click here to see the new Rotator Cuff Book
Information about shoulder exercises can be found at this link.
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, reverse total shoulder patient information, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
See from which cities our patients come.
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Data on the (1) organisms treated with the two stage procedure, (2) the success of the procedure in eliminating the infection, and (3) the comfort and function of shoulders having a two stage reimplantation are not provided.
Comment: This article documents that the two procedures that comprise a two-stage reimplantation for infection are just over twice as costly as a single stage primary. This analysis does not include the facts that (1) the risks and complications of two-stage reimplantation are also higher and (2) patients may choose not to have or may expire before the second stage.
For this reason, for most cases of infection we consider a single stage exchange as explained in this link and as demonstrated in this link. The cost for a single stage procedure is not substantially different from a primary arthroplasty. The advantages of the single stage include avoiding the risks, complications and costs of a second procedure. A two stage revision is considered for recurrent periprosthetic infections, infections with particularly virulent organisms, infections in patients with immunologic compromise, and those with draining sinuses.
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Consultation for those who live a distance away from Seattle.
Click here to see the new Shoulder Arthritis Book.
Click here to see the new Rotator Cuff Book
Information about shoulder exercises can be found at this link.
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, reverse total shoulder patient information, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
See from which cities our patients come.
See the countries from which our readers come on this post.
