BACKGROUND One-stage protocols for the management of periprosthetic infection take an extended period of time requiring two separate preps and sets of instruments to ensure optimal sterility. While intraoperative service time is one part of the reimbursement algorithm, reimbursement has lagged behind for single-stage treatment with respect to the time and resources necessary to perform these complex treatment regimens. If one-stage results are shown to be acceptable, but not reimbursed appropriately, surgeons will be discouraged from managing periprosthetic joint infection (PJI) in a one-stage fashion. METHODS The reimbursement and operative time for 50 PJI procedures were compared with 250 primary total hips and 250 primary total knees by the same 4 surgeons. RESULTS The average reimbursement for a one-stage knee procedure was $2,597.08, with an average intraoperative service time of 259 minutes ($601.60/h). The average reimbursement for a primary total knee was $2,435.00, with an average intraoperative service time of 100 minutes ($1,461/h). The average reimbursement for a one-stage hip procedure was $2,826.17, with an average intraoperative service time of 311 minutes ($545.24/h). The average reimbursement for a primary total hip was $2,754.71 with an average intraoperative service time of 104 minutes ($1,589.26/h). CONCLUSION One-stage procedures for PJI are reimbursed at approximately 1/3 the hourly rate of a primary procedure, which may discourage surgeons from selecting this treatment alternative even if recent studies confirm efficacy. Payers should be encouraged to reimburse physicians commensurate with the intraoperative service time needed to perform a one-stage procedure as adoption will decrease morbidity and save the healthcare system financially.

中文翻译：

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一阶段的假体周围关节感染报销-是否值得努力？

背景技术用于管理假体周围感染的一阶段方案需要较长的时间，需要两个分开的准备和一套仪器来确保最佳的无菌性。虽然术中服务时间是报销算法的一部分，但就执行这些复杂的治疗方案所需的时间和资源而言，单阶段治疗的报销已经落后。如果一阶段的结果被证明是可以接受的，但没有得到适当的补偿，则将不鼓励外科医生以一阶段的方式处理假体周围关节感染（PJI）。方法比较了4位外科医生对50例PJI手术的报销和手术时间与250例全髋关节和250例全膝关节的费用。结果，一阶段膝盖手术的平均报销为$ 2,597.08，平均术中服务时间为259分钟（$ 601.60 / h）。一次全膝总手术的平均报销为$ 2,435.00，平均术中服务时间为100分钟（$ 1,461 / h）。一阶段髋关节手术的平均报销为$ 2,826.17，平均术中服务时间为311分钟（$ 545.24 / h）。一次全髋关节的平均报销为$ 2,754.71，平均术中服务时间为104分钟（$ 1,589.26 / h）。结论PJI的一阶段手术费用约为初级手术每小时费用的1/3，即使最近的研究证实了疗效，也可能使外科医生不愿选择这种治疗方法。