Revision arthroplasty of the hip is expensive owing to the increased cost of pre-operative investigations, surgical implants and instrumentation, protracted hospital stay and drugs. We compared the costs of performing this surgery for aseptic loosening, dislocation, deep infection and peri-prosthetic fracture. Clinical, demographic and economic data were obtained for 305 consecutive revision total hip replacements in 286 patients performed at a tertiary referral centre between 1999 and 2008. The mean total costs for revision surgery in aseptic cases (n = 194) were £11 897 (sd 4629), for septic revision (n = 76) £21 937 (sd 10 965), for peri-prosthetic fracture (n = 24) £18 185 (sd 9124), and for dislocation (n = 11) £10 893 (sd 5476). Surgery for deep infection and peri-prosthetic fracture was associated with longer operating times, increased blood loss and an increase in complications compared to revisions for aseptic loosening. Total inpatient stay was also significantly longer on average (p < 0.001). Financial costs vary significantly by indication, which is not reflected in current National Health Service tariffs.
- Economic analysis
- Revision hip arthroplasty
- Hip replacement
- National tariff
- Payment by results
The authors would like to thank J. Cobb and J. Witt for allowing the inclusion of their patients into the analysis.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- Received March 5, 2011.
- Accepted January 25, 2012.
- ©2012 British Editorial Society of Bone and Joint Surgery