Cost-effectiveness of cemented versus cementless total hip arthroplasty. A Markov decision analysis based on implant cost.
BACKGROUND
Probabilistic decision analysis is a means of reflecting the uncertainty parameter in models and of presenting it in a comprehensible manner to decision-makers.


METHODS
A cost-effectiveness model was constructed to compare the cementless and cemented total hip prostheses implanted at our department in terms of lifetime costs and quality-adjusted life-years (QALY). Revision rates were obtained from the Orthopaedic Prosthesis Register of the Laboratory of Medical Technology, Istituti Ortopedici Rizzoli, Bologna, Italy.


RESULTS
The risk of early revision (at 5 years of follow-up) for cementless and cemented prostheses was 1.6% and 1.4%, respectively, resulting in equal QALY for the two implant types. Analysis of mean cost and QALY indicated that use of either implant is not associated with cost savings.


CONCLUSIONS
Management with cementless or cemented total hip prostheses in a theoretical cohort of 70-year-old patients with fracture of the femoral neck or arthritis involving the hip is not significantly different according to the probabilistic results from the model.
Marinelli
M
M
Department of Orthopaedics and Traumatology, University of the Marche, Ospedali Riuniti Via Conca, 60100, Ancona, Italy.
Soccetti
A
A
Panfoli
N
N
de Palma
L
L