A Decade in Periprosthetic Joint Infection Care: Growing Referrals and High Resource Demands at a High-Volume Center

Background The management of periprosthetic joint infection (PJI) requires a multidisciplinary approach that is not feasible in all healthcare settings. This study characterized the evolving burden of PJI referrals at an academic referral center over the past decade. Methods A retrospective review was conducted of all referred patients who underwent treatment for hip or knee PJI at a single referral center between 2014 and 2024. Demographic data, initial operative time, hospital length of stay (LOS), and number and duration of subsequent surgeries were recorded. Results In total, 523 referred patients were treated for PJI. The mean initial LOS was 7.0 days (standard deviation [SD] 5.7) and the mean operative time was 169.5 min (SD 75.9). Overall, 36% underwent irrigation and debridement with modular component exchange, single stage revision, or a spacer alone. Of the 335 who had at least 1 subsequent surgery, under half (N = 146, 43.5%), received stage two alone. On average, patients underwent 1.8 subsequent surgeries (SD 1.4), ranging from 1 to 14. The cumulative mean operative time for these subsequent surgeries was 306.4 min (SD 253.3). The number of PJIs nearly doubled from 2014-2017 (N = 112) to 2021-2024 (N = 221). There were no significant changes in LOS, number of subsequent surgeries, or cumulative operative time for reoperations during these intervals. Conclusions The volume of referred PJIs has increased substantially over the past decade at our referral center, underscoring the growing demand for PJI care and profound resource burden necessary to care for these patients.