Abstract
Widespread use of XLPE has reduced the incidence of both revision surgery and dislocations. This paper aims to create gross estimates of the magnitude of the resulting cost savings.
Data about decreasing rates of revision surgery and dislocations after THA, comparing XLPE versus CPE, were obtained from the literature along with figures for costs. Gross estimates were generated from these figures.
AOA NJRR 17 reports that at 15 years XLPE reduced the “all cause” revision rate of ceramic on polyethylene by 6.8% and at 16 years reduced the rate for metal on polyethylene by 6.5%. Their average 15 year figure was 4.8%, nearly in half. Dislocations were reduced by 24%. Other data substantiate these trends.
Inclusive costs of nonseptic revisions in US dollars, incorporating those relevant costs for the year prior to and the year following surgery, have been shown to average in the neighborhood of $55,000. Dislocations add further to the costs. The estimated savings from XLPE by 15 years on those total hip replacements done in one year in North America equal nearly $1 billion, even without incorporating any increase annually in the number done. While the specific savings in other countries with lower costs are less, similar proportions likely obtain. Despite all the assumptions, the magnitude is striking.
In addition to major benefits to the patients, the surgeons, and the hospitals, XLPE affords a massive advantage economically.
