Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/1442
Title: Fixation Method for Hip Arthroplasty Stem Following Hip Fracture: A Population-Level Cost-Effectiveness Analysis
Authors: Blythe, Robin
O'Gorman, Patricia 
Crawford, Ross W
Feenan, Rachel
Hatton, Alesha
Whitehouse, Sarah L
Graves, Nicholas
Issue Date: Jun-2020
Publisher: Elsevier Inc.
Source: Blythe R, O'Gorman PM, Crawford RW, Feenan R, Hatton A, Whitehouse SL, Graves N. Fixation Method for Hip Arthroplasty Stem Following Hip Fracture: A Population-Level Cost-Effectiveness Analysis. J Arthroplasty. 2020 Jun;35(6):1614-1621. doi: 10.1016/j.arth.2020.02.001
Journal: The Journal of arthroplasty
Abstract: Hip arthroplasty is increasing in Australia. The number of procedures for fractured neck of femur was 7500 in 2017. Best practices for fixation method and procedure type require scrutiny. This paper is about the costs and health outcomes of cemented and uncemented hemiarthroplasty and total hip arthroplasty at a national level. We created a Markov model for patients <75, aged 75-85, and over 85. Expected costs and health outcomes over 5 years from a decision to change from existing practice to a best practice policy in which all patients with fractured neck of femur received the same fixation method based on age and type of arthroplasty are estimated. The model was populated using prevalence and incidence data from the Australian Orthopedic Association National Joint Replacement Registry, costs from Metro North Hospital and Health Service in Queensland, and probabilities and utilities from the literature. We simulated the uncertainties in outcomes with probabilistic sensitivity analysis. We found that uncemented stem procedures were more costly and provided worse health outcomes compared to cemented stem fixation for hemiarthroplasty and total hip arthroplasty for all age groups. Moving from existing practice to cemented stem arthroplasty could save the Australian health system $2.0 million over 5 years with a gain of 203 quality-adjusted life years. We suggest that consideration be given to cemented fixation of the femoral stem for patients receiving both hemiarthroplasty and total hip arthroplasty for fractured neck of femur. Best practice guidelines focused on cost-effectiveness should recommend cemented stem fixation to both save costs and improve patient quality of life.
DOI: 10.1016/j.arth.2020.02.001
Keywords: Arthroplasty;Femoral Neck Fractures;Hemiarthroplasty;Hip Prosthesis;Fixation;Hip fracture;Reoperation
Type: Article
Appears in Sites:Gold Coast Health Publications

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