Abstract
INTRODUCTION
Computer navigation has been shown to decrease the variance of component positioning in primary THR. The cost of a navigation system in the U.S. however can exceed $200,000 in capital costs and $300–850 a case for disposables. Our objective was to assess the cost-utility of a hip navigation system.
METHODS
A review of the literature on costs and times for primary THR was done. Consecutive THR were done with an infrared navigation system. Total surgical time from incision to final skin closure and intra-operative time associated with the navigation process were recorded. Professional fees and the costs of revision surgery were estimated.
RESULTS
The average total surgical time for THR was 96.6 minutes ± 8.4 SE for the navigated cohort and 77 minutes ± 1.3 SE for the THR without navigation. Setup of patient trackers and surgical landmarks registration averaged 14.4 minutes for the navigated surgery. The total additional costs (increase in OR time, anesthesia professional fees and the disposable expenses) were $813 for a primary THR using navigation. Reduction by 50% in dislocation and revision rates will yield savings where the system will pay for itself in 5 years doing only 30 cases per year.
DISCUSSION AND CONCLUSION
Assuming 30% of all primary cases are performed with navigation, the incremental cost to the health care system would exceed $300 million a year. Depending on the model and assumptions used to calculate reduction in revisions and dislocations this system could be cost-effective for society if used in high-volume centers.
