IMMEDIATE SURGERY VERSUS WAITING LIST POLICY IN REVISION TOTAL HIP-ARTHROPLASTY - AN ECONOMIC-EVALUATION

An economic evaluation was carried out using a decision tree that mode ls the costs and consequences of surgery at the point of consultation versus a waiting List policy for candidates in need of revision hip ar throplasty. The theoretical scenarios looked at a a-year period wherei n the immediate surgery patients incurred costs for 2 years after surg ery, whereas the waiting list patients incurred costs for 1 year befor e and 1 year after surgery. Outcome probabilities were defined and app lied to each treatment group, as derived from the literature and exper t opinion. Expenditures were derived from the literature, based on con servative estimates of predicted pre- and postsurgical behavior for ea ch scenario. This analysis indicates the potential for both substantia l savings in resources and improved patient outcome for immediate surg ery over waiting lists. These savings would begin at the inception of the immediate surgery protocol. Sensitivity analysis indicates that th e conclusion is valid over a wide range of expenditures and probabilit ies. Key words: revision total hip arthroplasty, economic evaluation w aiting list, complications.