Abstract
Total hip arthroplasty (THA) is a common and extremely beneficial procedure that is being performed more often as the population ages. Current THA follow-up guidelines require large amounts of resources and may not justify their cost with increased patient outcomes. Most problems that would require THA revision will cause symptoms. Late-presenting asymptomatic THAs that are found to require revision are complicated and expensive to address and often lead to poor patient outcomes. Follow-up visits for THA patients are essentially a screening tool to identify asymptomatic THAs that require revision. The rate of asymptomatic THA revision and the subsequent cost of screening for them is not well reported in the literature. Given the relative shortage of orthopaedic resources, efficient use of clinic time should be a priority and inefficient practices should be identified and changed.
We calculated the rate of asymptomatic hip revisions over the first twenty years of THA ownership. We further calculated the cost of a single visit to the orthopaedic clinic for follow up of a THA. Finally, we calculated the cost savings of decreasing the follow-up schedule to a total of three visits.
The cost savings of foregoing the screening to identify one asymptomatic THA requiring revision is CAD $1.2 million.
Asymptomatic THAs requiring revision are rare and, as such, require a large amount of follow up to diagnose. As a screening tool, regular orthopaedic follow up of THA is an inefficient use of resources. Current follow-up guidelines are cost-prohibitive and should be made much less frequent in order to save resources.
