Cost-effectiveness model comparing dual-mobility to fixed-bearing designs for total hip replacement in France

Orthopaedics & Traumatology, Surgery & Research : OTSR
J-A EpinetteM Doz

Abstract

Instability is among the main causes of total hip arthroplasty (THA) failure. In clinical studies, THA with a dual-mobility cup (THA-DM) decreased the risk of instability after primary THA compared to THA with a fixed-bearing design (THA-FB). However, whether THA-DM is more cost-effective than THA-FB has not been established using Markov modelling with determination of the incremental cost-effectiveness ratio (ICER). The objectives of this work were to: (1) measure the efficiency of these two options, (2) use the nationwide hospital electronic database (PMSI) to estimate direct costs of dislocations and revisions for instability, and (3) conduct deterministic and probabilistic sensitivity analyses to estimate potential mean annual cost-savings in France. We hypothesised that primary THA-DM was cost-saving compared to primary THA-FB. In the database, we identified 80,405 patients who had THA in 2009 and we collected their outcomes over 4 years (2009-2012). Cost-effectiveness was assessed based on the costs of resources used for all consequences of prosthetic dislocation and paid for by the statutory health insurance system or other sources. THA-DM was associated with a relative risk of dislocation of 0.4 versus THA-FB. This risk...Continue Reading

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Citations

Mar 5, 2016·Orthopaedics & Traumatology, Surgery & Research : OTSR·B Dervaux
Dec 4, 2019·Clinical Orthopaedics and Related Research·Julien WegrzynJacques Béjui-Hugues
Aug 31, 2020·The Bone & Joint Journal·Amir KhoshbinAmit Atrey
Feb 9, 2017·International Journal of Epidemiology·Thierry Boudemaghe, Ihssen Belhadj
Mar 10, 2017·Expert Review of Medical Devices·Hamed VahediJavad Parvizi
Oct 11, 2019·EFORT Open Reviews·William G BlakeneyPascal-André Vendittoli
Jun 10, 2020·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Syed H MufarrihShahryar Noordin
Nov 23, 2019·EFORT Open Reviews·Rory CuthbertParag Kumar Jaiswal
Dec 4, 2020·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Rocco D'ApolitoLuigi Zagra
Jan 16, 2021·The Journal of Arthroplasty·Jonathan M VigdorchikAndrew J Shimmin
Apr 4, 2021·Geriatrics·José María Lamo-EspinosaJuan Ramón Valentí-Nin
Apr 13, 2021·SICOT-J·Andreas FontalisFares S Haddad
Apr 9, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Antoine HoestlandtJulien Girard
Apr 13, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Ragna C JonkerRudolf W Poolman
Aug 21, 2021·International Orthopaedics·Freddy Mertens BombahAn Sermon
Sep 10, 2021·Zeitschrift für Orthopädie und Unfallchirurgie·Petri BellovaKlaus-Peter Günther

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