Comparison of health care costs between aseptic and two stage septic hip revision

Grit Assmann; Richard Kasch; Christopher G Maher; André Hofer; Thomas Barz; Harry Merk; Steffen Flessa

doi:10.1016/j.arth.2014.04.043

Comparison of health care costs between aseptic and two stage septic hip revision

J Arthroplasty. 2014 Oct;29(10):1925-31. doi: 10.1016/j.arth.2014.04.043. Epub 2014 May 9.

Authors

Grit Assmann¹, Richard Kasch², Christopher G Maher³, André Hofer⁴, Thomas Barz⁵, Harry Merk⁴, Steffen Flessa¹

Affiliations

¹ Department of Health Care Management, Faculty of Law and Economics, Ernst-Moritz-Arndt-University, Greifswald, Germany.
² Clinic and Outpatient Clinic for Orthopaedics and Orthopaedic Surgery, University Medicine Greifswald, Greifswald, Germany; The George Institute, The University of Sydney, Sydney, Australia. Electronic address: richard.kasch@uni-greifswald.de.
³ The George Institute, The University of Sydney, Sydney, Australia.
⁴ Clinic and Outpatient Clinic for Orthopaedics and Orthopaedic Surgery, University Medicine Greifswald, Greifswald, Germany.
⁵ Department of Orthopaedics and Trauma Surgery, Asklepios Hospital Uckermark, Schwedt, Germany.

PMID: 24927869
DOI: 10.1016/j.arth.2014.04.043

Abstract

The number of septic and aseptic total hip arthroplasty (THA) revisions will increase, which involves a greater financial burden. We here provide a retrospective consecutive analysis of the major variable direct costs involved in revision THA for aseptic and septic failure. A total of 144 patients (30 septic, 114 aseptic) treated between January 1, 2009 and March 31, 2012 was included. The management of septic THA loosening is much more expensive than that of aseptic loosening ($14,379.8 vs. $5,487.4). This difference is mainly attributable to the two-stage exchange technique used for septic failure (hospital stay: 40.2 vs. 15.6 days) and significantly higher implant costs ($3,930.9 vs. $2,298.2). The septic implantation part is on average $3,384.6 more expensive than aseptic procedures (P < .001).

Keywords: Cost comparison; THA revision; aseptic; economic analysis; septic.

Publication types

Comparative Study

MeSH terms

Aged
Arthroplasty, Replacement, Hip / economics*
Arthroplasty, Replacement, Hip / methods
Device Removal / economics
Female
Health Care Costs*
Hip Prosthesis / economics
Humans
Male
Middle Aged
Prosthesis Failure
Prosthesis-Related Infections / economics*
Reoperation / economics
Reoperation / methods
Retrospective Studies