Cost-effectiveness analysis of custom-made and serial acetabular components in revision hip arthroplasty

Abstract

Introduction Custom-made acetabular componenents demonstrate a higher clinical efficiency in revision hip arthroplasty for 3A and 3B uncontained acetabular defects and pelvic discontinuity in comparison with serial implants. However, the cost of customized implants still outweighs the cost of serial implants. Accordingly, the level of economic feasibility of using different implants for various defects of the acetabulum seems to be interesting to investigate. Purpose To analyze the economic efficiency of using customized acetabular implants for 3A and 3B uncontained acetabular defects and pelvic discontinuity in comparison with serial implants. Materials and methods To assess the economic efficiency, the Markov model was applied. The model was built on the basis of 4-year survival data for aseptic loosening, infection, and dislocation in 133 cases of revision hip arthroplasty. Results According to the results of modeling, over a 5-year cycle, customized implants showed a reduction in costs by 11.7 % and an increase in the quality of life of patients by 0.2 QALY in the group of patients with 3A uncontained defects in comparison with serial implants. In patients with 3B uncontained defects and pelvic discontinuity, custom-made implants also showed a reduction in costs by 20.8 % and 41.1 %, and QALY values were also higher in the groups of patients who had custom-made implants at 0.6 and 1.4 QALY units, respectively. Conclusion The use of custom-made implants is a more cost-effective strategy in comparison with the implantation of serial acetabular components.

Keywords

• revision hip arthroplasty
• cost-effectiveness
• custom-made acetabular implants
• serial acetabular constructs