Can different stem design impact hospital healthcare resource utilization following total hip arthroplasty: a...

This retrospective observational study was designed to evaluate healthcare resource utilization and hospital costs among patients who underwent total hip arthroplasty (THA) with a cementless, medial collared, triple tapered femoral stem (TTS) compared to the morphometric wedge (MMW) design based femoral stems.

Patients >21 years of age, undergoing cementless THA from January 2016-September 2023, and implanted with TTS vs. MMW, in Premier Healthcare Database were analyzed. Primary outcomes included length of hospital stay and 90- and 365-day all-cause readmission. Cohorts were balanced using covariate balance propensity score method and generalized linear model was used to compute outcomes.

14,238 TTS and 17,578 MMW patients were included in the analysis. Balanced cohorts had an average age of 66 years. Length of stay was significantly shorter for TTS (1.65 days vs. 1.93 days for control, p-value < 0.01). The 90-day all-cause readmission rate was 2.62% for TTS and 3.15% for MMW and the mean difference of 0.52% [0.13% to 0.92%] was significantly lower (p-value < 0.01) for TTS. The mean difference for 365-day all-cause readmission was also significantly lower for TTS (1.19% [0.53% to 1.84%], p-value < 0.01). Fewer patients were discharged to a skilled nursing facility and total cost of care at 365-day follow-up was lower for TTS compared to the MMW cohort.

The comparative analyses showed favorable outcomes for the TTS cohort in terms of shorter length of stay, fewer all-cause readmissions, fewer discharges to skilled nursing facility and lower cost at 365-day follow-up compared to MMW.