Abstract
Introduction
Periprosthetic osteolysis (PPO) gradually became the single dominant late failure mechanism of total hip replacements. It afflicted 1 million patients worldwide, leading to countless, difficult revision operations. The widespread adoption of highly cross-linked polyethylene (XLPE) drastically reduced that disease. But going beyond that remarkable reversal, two further substantial consequences have resulted: A) a major reduction in revision operations and B) a major reduction in aggregate costs of total replacement surgery. This paper assembles data on the decrease in revision rates and uses them to estimate the massive reduction in total hip surgery costs.
Methods
Review the literature produced registry data and controlled studies data establishing that XLPE reduced the “all cause” revision rate over the first 15 years of follow-up of total hip replacements at least in half, and often more.
A conservative estimate of the number of revisions annually in the United States is 50,000. A conservative estimate of the average, integrated cost for a THR revision in the United States is $50,000, meaning that the costs of these revisions annually is at least $2.5 billion.
Using a very conservative figure of just 40% for the percent reduction in revision surgery resulting from the use of XLPE reduces this burden by at least $1 billion annually.
Conclusion
In addition to the remarkable benefits to patients from XLPE, the resulting dramatic reduction in revision rate provides a remarkable reduction in aggregate costs.
