Related Experiment Video
Updated: Jul 4, 2026
09:51
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Cost-effectiveness analysis of periacetabular osteotomy
Emile Sharifi1, Husham Sharifi, Saam Morshed
1School of Medicine, University of California at San Francisco, 513 Parnassus Avenue, San Francisco, CA 94143, USA.
Summary
Periacetabular osteotomy is more cost-effective for Tönnis grade-1 and grade-2 coxarthrosis than total hip arthroplasty. It is less effective and more costly for Tönnis grade-3 coxarthrosis, where total hip replacement is preferred.
Area of Science:
- Orthopedic surgery
- Health economics
Background:
- Limited long-term data for periacetabular osteotomy (PAO) hinders optimal procedure selection for young adults.
- Cost-effectiveness analysis is crucial for comparing joint-preserving procedures like PAO with total hip arthroplasty (THA).
Purpose of the Study:
- To compare the cost-effectiveness of PAO versus THA in young adults.
- To determine the cost per quality-adjusted life year (QALY) for each procedure.
Main Methods:
- A decision model was developed for a cost-utility analysis.
- Outcome probabilities and effectiveness (QALYs) were literature-derived.
- Cost data were collected from institutional sources and discounted.
Main Results:
- PAO dominates for Tönnis grade-1 coxarthrosis ($7856/QALY, 0.15 incremental effectiveness).
- For Tönnis grade-2 coxarthrosis, PAO is more cost-effective ($824/QALY) but less effective (-1.4 QALYs).
- PAO becomes cost-effective at 5.5 years (grade 1) and 18.25 years (grade 2); THA dominates for Tönnis grade-3 coxarthrosis.
Conclusions:
- PAO is more cost-effective for Tönnis grade-1 and grade-2 coxarthrosis.
- PAO is more costly and less effective for Tönnis grade-3 coxarthrosis, favoring THA.
- Findings support PAO for younger patients prioritizing sports function in early-stage coxarthrosis.