In-hospital cost comparison between the standard lateral and supercapsular percutaneously-assisted total hip surgical techniques for total hip replacement.

Wade Gofton,David A Fitch

doi:10.1007/s00264-015-2878-4

Abstract

The purpose of this study was to compare the in-hospital costs associated with the tissue-sparing supercapsular percutaneously-assisted total hip (SuperPath) and traditional Lateral surgical techniques for total hip replacement (THR). Between April 2013 and January 2014, in-hospital costs were reviewed for all THRs performed using the SuperPath technique by a single surgeon and all THRs performed using the Lateral technique by another surgeon at the same institution. Overall, costs were 28.4% higher in the Lateral group. This was largely attributable to increased costs associated with transfusion (+92.5%), patient rooms (+60.4%), patient food (+62.8%), narcotics (+42.5%), physical therapy (+52.5%), occupational therapy (+88.6%), and social work (+92.9%). The only costs noticeably increased for SuperPath were for imaging (+105.9%), and this was because the SuperPath surgeon performed intraoperative radiographs on all patients while the Lateral surgeon did not. The use of the SuperPath technique resulted in in-hospital cost reductions of over 28%, suggesting that this tissue-sparing surgical technique can be cost-effective primarily by facilitating early mobilisation and patient discharge even during a surgeon's initial experience with the approach.

Highlights

The economic burden of osteoarthritis (OA) continues to grow as rising life-expectancy and obesity rates contribute to increased incidence of the condition
In-hospital costs were reviewed for all SuperPath Total hip replacement (THR) performed by a single surgeon and all standard Lateral THRs performed by another surgeon at the same institution between April 2013 and January 2014
There were SuperPath and Lateral THRs performed during the selected time period

Summary

Introduction

The economic burden of osteoarthritis (OA) continues to grow as rising life-expectancy and obesity rates contribute to increased incidence of the condition. Total hip replacement (THR) is one of the most common treatments of OA in the hip joint, with annual volumes expected to reach 572,000 THRs in the United States alone by 2030 [2]. THR represents an excellent target for reducing the overall economic burden of OA. One aspect of THR with the potential to reduce costs is the surgical technique. That study provided examples of postdischarge cost savings associated with the reduction of these key variables. This is significant as post-discharge costs have been shown to account for nearly 40 % of a THR episode of care [5]

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