Will 2011 be an austerity year for healthcare? "Premium" implants may not add value.

Published date : 30 December 2010
Article date : 30 December 2010

In a paper in the January 2011 issue of Clinical Orthopaedics and Related Research, Gloe et al have used a community joint registry in an attempt to identify whether "premium" implants demonstrably add value to hip and knee replacement procedures. "Premium" knee replacements were defined as mobile bearing, high flexion, oxidised-zirconium femoral components or cross linked polyethylene. "Premium" hip replacements included those with ceramic on ceramic, ceramic on polyethylene or metal on metal bearings.  Unsurprisingly perhaps, younger patients were more likely to have received a "premium" implant, but there was no difference in the cumulative revision rate, although there were fewer revisions for dislocation in the "premium" hip group, in which large bearings were used more frequently.

The authors make the point that several papers have shown no obvious superiority of high-flexion knees, mobile bearing knees, oxidized zirconium femoral components or moderately cross-linked polyethylene inserts, compared to standard lower cost implants. However, they also point out that more follow up is needed and their study could not assess any functional benefit from "premium" implants.
 
We think 2011 could see more studies along these lines, and a renewed focus on value for money. What do you think? Please comment on our forum...
 
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