Researchers used Markov decision modeling to determine the two implants' cost-effectiveness and revision rates. They reviewed data from 20,389 patients who were 45-years-old or older in 2012 and underwent total hip arthroplasty.
Here's what they found.
1. Ceramic heads' cost effectiveness varied depending largely on the patients' age.
2. At a cost differential of $325, ceramic-on-polyethylene bearings were cost-effective for patients 85-years-old or higher.
3. At $600, the ceramic-on-polyethylene bearings were cost-effective in patients 65-years-old or higher.
4. At $1,003, the ceramic-on-polyethylene bearings were not cost effective for any age.
5. The researchers concluded, "The ability to recoup the initial increased expenditure of ceramic heads through a diminished lifetime revision cost is dependent on the price premium for ceramic and the age of the patient. A wholesale switch to ceramic bearings regardless of age or cost differential may result in an economic burden to the health system."
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