Worldwide guidelines to follow-up MoM hips likely not cost effective
A recently study indicated follow-up guidelines worldwide lack the ability to detect adverse reaction metal debris lesions after metal-on-metal hip arthroplasty and they are not cost effective or evidence-based.
Researchers compared follow-up guidelines for metal-on-metal (MoM) hip arthroplasty from five worldwide authorities worldwide, including the U.K. Medical and Healthcare Products Regulatory Agency (MHRA), European Federation of National Associations of Orthopaedics and Traumatology (EFORT), FDA, Therapeutic Goods Administration of Australia and Health Canada. They assessed the guidelines for published evidence and their financial implications of hip resurfacing and total hip arthroplasties (THA).
Findings showed large differences among the authorities in cost per patients. U.S. costs were three-times more than MHRA costs, for example. A large population survey showed a very large difference in costs between authorities. The most costly protocol for surveillance of all symptomatic patients with MoM arthroplasty was the FDA. The cheapest annual follow-up guidance was from MHRA. The FDA and EFORT follow-up was three-times more costly to perform.
Australia vs. U.S. and Canada guidelines were about six-times more costly for asymptomatic patients. Of all the authorities, the EFORT guidelines were most expensive when recent data were used to classify a large amount of resurfaced hips as asymptomatic, the study showed. ‒ by Monica Jaramillo
Disclosures: Matharu reports he received a Surgical Research Fellowship awarded from The Royal College of Surgeons of England and other financial and material support from the Arthritis Research Trust.