THE TOTAL-COST OF HIP-JOINT REPLACEMENT - A MODEL FOR PURCHASERS

A computer-based model is used to investigate the total cost of primar y total hip-joint replacement. The model takes into account the probab ility of prosthesis failure, death and re-revision. The results emphas ize the importance of age at insertion, demonstrating that the expecte d life-span of the patient has a major influence on the total cost for a given prosthesis. The discussion considers the idea of a 'lifetime care package' to encapsulate the concept of quality when considering t he purchasing of total hip replacements. If it is assumed that a prima ry replacement episode costs pound 3500 and revision surgery costs twi ce as much, then the additional premium on the best implant currently available would be pound 630. The premium payable on the same patient using the worst design would be pound 3080. This difference reflects t he importance of quality in total hip replacement surgery.