COST-EFFECTIVENESS OF EARLY SURGICAL INTERVENTION IN SILENT OSTEOLYSIS

Access to subspecialty care is the subject of significant controversy. Most managed-care systems closely monitor the number of specialist re ferrals as well as x-rays ordered for patients with no symptoms, but l arge lytic lesions can exist around implants without any pain. Interve ntion costs were calculated for 2 groups of patients: 1 group with sil ent lysis with no symptoms and another group with periprosthetic fract ures around lytic lesions. The costs were significantly higher in the group in which the fractures occurred versus the group in which early intervention was performed. Early diagnosis of structurally critical l ytic lesions around implants by routine follow-up monitoring is recomm ended for all joint replacement patients.