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Future Clinical and Economic Impact of Revision Total Hip and Knee Arthroplasty
Steven M. Kurtz, PhD; Kevin L. Ong, PhD; Jordana Schmier, MA; Fionna Mowat, PhD; Khaled Saleh, MD, MSc, FRSCS; Eva Dybvik, MSc; Johan Kärrholm, MD, PhD; Göran Garellick, MD, PhD; Leif I. Havelin, MD, PhD; Ove Furnes, MD, PhD; Henrik Malchau, MD, PhD; Edmund Lau, MS
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. A commercial entity (The Swedish Association of Local Authorities and Regions [SALAR] Region Västra Götaland) paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which one or more of the authors, or a member of his or her immediate family, is affiliated or associated.
Note: The authors thank the Swedish National Hip Arthroplasty Register and the Norwegian Arthroplasty Register for providing the study team with extracts from their respective registry databases.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Oct 01;89(suppl 3):144-151. doi: 10.2106/JBJS.G.00587
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A recent analysis of historical procedure data indicated that the prevalence of primary and revision total hip and total knee arthroplasty increased steadily between 1990 and 20021. A massive demand for primary and revision surgeries is also expected in the next two decades2. Similarly, the overall incidence of deep infection also has increased substantially between 1990 and 2003 for both total hip arthroplasty and total knee arthroplasty3. In 2003, approximately 1.2% of the total hip arthroplasties performed in the United States were associated with deep infection, which was similar to the rate seen for total knee arthroplasties3. Deep infection is a catastrophic complication of both total hip and total knee arthroplasty, and it also represents a tremendous economic burden4,5. The implications for a growing incidence of infections, coupled with accelerating demand for arthroplasty, remain unexplored.
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