Prosthetic joint infection after hip and knee arthroplasty: Ten-year analysis of revision surgeries and clinical economic outcomes in Brazil

This study aimed to describe the epidemiological, clinical, and economic profile of revision surgeries performed in Brazil between 2014 and 2024 for the treatment of prosthetic joint infection (PJI) following hip and knee arthroplasty. A descriptive and exploratory analysis was conducted using data extracted from the DATASUS/TABNET platform. The variables analyzed included the total number of arthroplasties, revision surgeries due to PJI, number of deaths, mean length of hospital stay, and total hospital costs, stratified by year and geographic region. Annual revision and mortality rates were calculated with 95% confidence intervals (CI), along with descriptive statistics (mean, median, and standard deviation), using Stata version 14. Between 2014 and 2024, a total of 410,611 hip and knee arthroplasties were performed in Brazil, with 6,047 revision surgeries attributed to PJI, corresponding to a mean revision rate of 1.62%. The highest annual revision rate was observed in 2021 (2.08%). Overall mortality related to revision surgeries totaled 389 deaths, with a peak mortality rate of 6.88% in 2023. The mean length of hospital stay was 14.37 days. The average annual hospital cost was R$160,423.20, representing a 61.5% increase over the study period. The Southeast region accounted for more than 60% of both procedures and total costs. Revision surgeries for prosthetic joint infection increased in Brazil between 2014 and 2024 and were associated with high postoperative mortality and a substantial economic burden, particularly during the COVID-19 pandemic. Although revision rates were comparable to those reported internationally, the concentration of procedures, costs, and outcomes highlights regional disparities in orthopaedic care. These findings reinforce the need for strengthened national surveillance strategies and the implementation of a comprehensive arthroplasty registry to support infection prevention and healthcare planning in Brazil.