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Cost-effectiveness of cemented versus cementless total hip arthroplasty. A Markov decision analysis based on implant
M Marinelli1, A Soccetti, N Panfoli
1Department of Orthopaedics and Traumatology, University of the Marche, Ospedali Riuniti Via Conca, 60100, Ancona, Italy.
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.
Materials And 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.
Discussion:
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.
