Cost-Utility Analysis of Total Hip Arthroplasties: Technology Assessment of Surgical Procedures by Mailed Questionnaires

Abstract

A retrospective study comparing 700 consecutive total hip arthroplasties, utilizing four types of implants, was performed. Questionnaires based on hip scores were sent to 593 living patients. Useful responses were received from 363 (61%) patients. Hip scores and quality-adjusted life-years were calculated. Multiple regression analysis, controlling for all possible biases, demonstrated one cementless implant as superior to all others. We believe that the use of mailed questionnaires is a simple and convenient system of follow-up, saving patients the need for outpatient clinic visits. The validity of such replies, however, has yet to be established.

Use of Cost-Effectiveness Analysis to Evaluate New Technologies in Orthopaedics: The Case of Alternative Bearing Surfaces in Total Hip Arthroplasty

“…Specific utility values for each health state considered in the model were derived from the literature [28][29][30][31] . On the basis of previous studies in which investigators measured healthstate utilities associated with total hip arthroplasty 28,32-34 , a utility value of 0.92 was chosen as a baseline value for a successful total hip arthroplasty.…”

Socioeconomic value of orthopedic devices: evidence and methodological challenges

“…11,12 Total hip and knee replacement brought about improvements in clinical rating scores, ranging from an additional 25-35 points in hip scores and 15-56 points in knee scores. [14][15][16][17][18] In addition, improvements in functional health and well-being scores were found across several studies, as well as in other healthrelated quality of life measures, eg, pain, sleep, and mobility. Such improvements resulted in an average gain in QALYs of 2.01 (−0.02 to 6.88).…”

“…Such improvements resulted in an average gain in QALYs of 2.01 (−0.02 to 6.88). 17,[19][20][21][22][23] Similar to estimates of therapeutic benefit, there was significant variability in cost estimates, depending on the technology under review, comparator(s) used, patient population, study time horizon, and cost methodology used. However, in the case of hip protectors, use almost always resulted in cost-savings ($68-$230 per person).…”

“…[9][10][11][12][13] For the two studies comparing cementless and cemented hip implants, the ICER ranged from $91 to $1815 (estimates converted to 2010 US dollars). 17,29 However, these summary data often disguise a much more complex situation. In particular, most economic evaluations are subject to considerable uncertainty in the input parameters.…”

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