title: The economics of new age arthroplasty: can we afford it?
abstract: New technology in joint replacement design and materials adds cost that must be documented by improved outcomes. This is not always the case as the recent metal/metal data has shown. The current economics of arthroplasty have put increasing financial pressure on hospitals and will progress under new health care legislation. New technology must be cost-effective and this will be increasingly difficult in an era of outstanding long-term results with current designs. Cost may necessitate less expensive alternatives, eg, generic implants, in arthroplasty patients. Joint replacement surgery has evolved over the past 4 decades into a highly successful surgical procedure. Earlier designs and materials that demonstrated inferior functional and long-term results have disappeared in a Darwinian fashion. Through this evolutionary process many of the current designs have proven efficacy and durability. Current outcome data indicates that hip and knee designs demonstrate 90% to 95% success rates at 15-year follow-up. Technologic advances are necessary to improve implant design and materials, however, only in an environment of reduced reimbursement to hospitals can the increase cost be justified.
authors.affiliation: Hospital for Special Surgery, New York, New York, USA. sculcot@hss.edu
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Sculco
mesh_terms: D019643:Arthroplasty, Replacement / Q000191:economics* / Q000639:trends; D003362:Cost-Benefit Analysis; D017721:Hospital Costs; D006801:Humans; D007595:Joint Prosthesis / Q000191:economics*; D011474:Prosthesis Design; D012371:Robotics; D025321:Surgery, Computer-Assisted; D014481:United States