Do the potential benefits of metal-on-metal hip resurfacing justify the increased cost and risk of complications?
| Autor: | Marc D. Silverstein, Christine M. Pui, Matthew J. Ludeman, Thomas P. Vail, Kevin J. Bozic |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Comparative Effectiveness Research Time Factors Cost effectiveness Arthroplasty Replacement Hip medicine.medical_treatment Cost-Benefit Analysis Replacement Sports Medicine Osteoarthritis Hip Quality of life Models Risk Factors Medicine & Public Health Medicine Orthopedics and Sports Medicine health care economics and organizations Cost–benefit analysis Age Factors General Medicine Health Care Costs Health Services Middle Aged Hip resurfacing Markov Chains Models Economic Treatment Outcome Metals Female Quality-Adjusted Life Years Risk assessment musculoskeletal diseases medicine.medical_specialty Clinical Sciences Bioengineering Economic Prosthesis Design Surgical Orthopedics Risk Assessment Arthroplasty Sex Factors Clinical Research Osteoarthritis Humans Aged Medicine/Public Health general Hip surgery Symposium: Complications of Hip Arthroplasty Hip Conservative Orthopedics business.industry Arthritis Patient Selection Decision Trees Quality-adjusted life year Orthopedics Cost Effectiveness Research Physical therapy Surgery Hip Prosthesis business Decision analysis |
| Zdroj: | Clinical orthopaedics and related research, vol 468, iss 9 Bozic, Kevin J.; Pui, Christine M.; Ludeman, Matthew J.; Vail, Thomas P.; & Silverstein, Marc D.(2010). Do the Potential Benefits of Metal-on-Metal Hip Resurfacing Justify the Increased Cost and Risk of Complications?. Clinical Orthopaedics and Related Research®, 468(9), pp 2301-2312. doi: 10.1007/s11999-010-1301-0. Retrieved from: http://www.escholarship.org/uc/item/0g38g110 Clinical Orthopaedics and Related Research |
| DOI: | 10.1007/s11999-010-1301-0. |
| Popis: | Background Metal-on-metal hip resurfacing arthroplasty (MoM HRA) may offer potential advantages over total hip arthroplasty (THA) for certain patients with advanced osteoarthritis of the hip. However, the cost effectiveness of MoM HRA compared with THA is unclear. Questions/purposes The purpose of this study was to compare the clinical effectiveness and cost-effectiveness of MoM HRA to THA. Methods A Markov decision model was constructed to compare the quality-adjusted life-years (QALYs) and costs associated with HRA versus THA from the healthcare system perspective over a 30-year time horizon. We performed sensitivity analyses to evaluate the impact of patient characteristics, clinical outcome probabilities, quality of life and costs on the discounted incremental costs, incremental clinical effectiveness, and the incremental cost-effectiveness ratio (ICER) of HRA compared to THA. Results MoM HRA was associated with modest improvements in QALYs at a small incremental cost, and had an ICER less than $50,000 per QALY gained for men younger than 65 and for women younger than 55. MoM HRA and THA failure rates, device costs, and the difference in quality of life after conversion from HRA to THA compared to primary THA had the largest impact on costs and quality of life. Conclusions MoM HRA could be clinically advantageous and cost-effective in younger men and women. Further research on the comparative effectiveness of MoM HRA versus THA should include assessments of the quality of life and resource use in addition to the clinical outcomes associated with both procedures. Level of Evidence Level I, economic and decision analysis. See Guidelines for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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