Introduction

Total knee and hip arthroplasty were the main arthroplasty surgery performed in Brazil. In Brazil, around 50% of arthroplasty surgeries are performed by the public health system, knowing as SUS ¹. SUS is the biggest public and universal health system in the world, attending 100% of the Brazilian population (220 million), with 2020's expected budget of US$ 31 billion ^2,3.

The National Institute of Clinical Excellence utilizes the QALY system (Quality adjustment year life)to calculate the best cost-benefit between medical interventions ⁴. In compliance with the study, an operated person has a QALY index of £5000 while a non-operated person has an index of £7182.

In March 2020, due to the COVID-19 pandemics, the Brazilian Health Ministry oriented for the postponing of elective surgery, to prioritize combating the virus ⁵. This postponing, it was important but will cause an impact in the economy at the public health system from Brazil this year and in the next years. Therefore, this study aims to present the economic impact caused by COVID-19 pandemics in the public heal system, SUS, of Brazil.

Introduction

According to American Joint Replacement Registry, particle mediated osteolysis represents 13 % of the knee revision surgeries performed in the United States. The comprehension of mechanical and wear properties of materials envisioned for TJR is a key step in product development. Furthermore, the maintenance of UHMWPE mechanical properties after material modification is an important aspect of material success. Initial studies conducted by our research group demonstrated that the incorporation of ibuprofen in UHMWPE had a minor impact on UHMWPE physicochemical and mechanical properties. Drug release was also evaluated and resulted in an interesting profile as a material to be used as an anti-inflammatory system. Therefore, the present study investigated the effect of drug release on the mechanical and biological properties of ibuprofen-loaded UHMWPE.