Consider the potential cost-savings of dual mobility over conventional THA bearings
Message from Geoffrey H. Westrich, MD
Hospital for Special Surgery, New York, NY
What options are you considering to bring value and drive cost-savings? Studies show that hip instability/dislocation and mechanical loosening are the most common causes for revision THAs worldwide.1-5 The annual overall cost on the U.S. healthcare system to treat dislocation is an estimated $74 million.6 That's a staggering number and one we can potentially affect. How?
One option I recommend is introducing dual mobility to your appropriate primary hip cases to potentially reduce the cumulative costs associated with Total Hip Arthroplasty.
In one of my recent studies at Hospital for Special Surgery, we compared Stryker's Modular Dual Mobility System (MDM), to conventional bearings for primary THA using a computer-based cost-utility model.6 What we found in this economic analysis was that dual mobility procedures exhibited absolute dominance over conventional THA procedures in overall procedural costs.6 MDM constructs were not only cost-effective, but were actually cost saving over a conventional bearing, even when accounting for standard hospital readmission rates along with costs associated with the implants and revisions.6
There are several primary THA patient profiles that I consider ideal candidates for MDM: patients at high risk of dislocation including those with spinal fusion or with very stiff spines, those exhibiting spinal arthritis for example, or those on the opposite end of the spectrum, patients who are very active and need additional range of motion, such as yoga enthusiasts.
When I use dual mobility:
Revision:
- Dislocation
High-risk primary:
- Mental disability
- Neuromuscular disease
- Acute formal neck fracture
- Spinal fusions
- Dysplastic hips
- Small acetabulums
Primary:
- High demand patients
MDM is a great solution for the right patient population to address the most common reasons for failure after THA, which may help to minimize your cost burden at your hospital. If you’re looking to be more cost conscious, consider trying MDM for your next high-risk or high-demand patient.
References:
- Epinette, J. et al. Early experience with dual mobility acetabular system featuring highly crosslinked polyethylene liners for primary hip arthroplasty in patients under fifty-five years of age: an international multi-center preliminary study. International Orthopaedics (SICOT). 2017:41(3): 543-50.
- Jauregui, J. et al. Dual mobility cups: an effective prosthesis in revision total hip arthroplasties for preventing dislocations. Hip Int. 2016 ;26(1):57-61.
- Mont, Ma. Et al. The Use of Dual-Mobility Bearings in Difficutl Hip Arthroplasty Reconstructive Cases. Surg Technol Int. 2011 21:234-40.
- Australian Orthopaedics Association National Joint Replacement Registry 2017.
- Sanchez-Sotelo J. et al. Hospital Cost of Dislocation After Primary Total Hip Arthroplasty. J Bone Joint Surg Am 2006; 88:290-94.
- Barlow, B; McLawhorn, A; Westrich, G. The Cost Effectiveness of Dual Mobility Implants for Primary Total Hip Arthroplasty: A Computer-Based Cost-Utility Model. J Bone Joint Surg Am. 2017: 99:768-77.
A surgeon must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense medical advice and recommends that surgeons be trained in the use of any particular product before using it in surgery.
The information presented is intended to demonstrate the breadth of Stryker's product offerings. A surgeon must always refer to the package insert, product label and/or instructions for use before using any of Stryker's products. Products may not be available in all markets because product availability is subject to the regulatory and/or medical practices in individual markets. Please contact your sales representative if you have questions about the availability of products in your area.
The information contained in this document is intended for healthcare professionals only. Dr. Westrich is a paid consultant of Stryker.
Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: MDM, Stryker. All other trademarks are trademarks of their respective owners or holders.
MDM-COM-5_16494