The economics of preventing revisions in total hip replacement

We showed that the selection of a cost-effective type of cement and method of prophylaxis against deep infections for patients undergoing total hip re placement depended on the number of arthroplasties performed each year at i ndividual hospitals. When 100 arthroplasties were performed each year, the use of Palaces cement and systemic antibiotics reduced the total costs to t he department, i.e., the cost of cement, infection prophylaxis and revision s. The use of gentamicin-impregnated cement in combination with systemic an tibiotics will further reduce the risk of revision and is another cost-effe ctive strategy. The most effective infection prophylaxis would be achieved with a combination of gentamicin-impregnated cement, systemic antibiotics a nd surgical enclosure. However, the additional cost of the surgical enclosu re would not be offset by cost savings due to reduced risk of revisions.