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Hip replacement improves function, saves money, at any age
June 17, 2008Researchers say procedure is cost-effective with no age limit for benefits to patients
(DURHAM, NC) - Seniors with osteoarthritis who undergo total hip replacement are twice as likely as those who do not to show improvements in physical functioning and increased ability to care for themselves, according to researchers at Duke University Medical Center.
The study, which is the largest of its kind conducted to date, found that there is no age limit on the benefits of hip replacement for patients.
Researchers found that total hip replacements provide a cost savings to the health care system because reimbursement for the procedure (averaging $4,000 - $6,000) proves less costly than the long-term cost of health care for the disabled.
In addition to improved quality of life, health economists estimate savings associated with a year of a disability-free life at approximately $50,000, including all related health-care costs incurred by disabled patients such as hospital stays, nursing homes and home health care.
"We found that total hip arthroplasty improves everyday life for patients and is as beneficial to people in their 80s or 90s as it is for someone in their 60s," said Linda George, Ph.D., professor of Sociology and associate director of the Duke Center for the Study of Aging.
"While the number of surgeries conducted in the U.S. has increased dramatically over the last decade, fewer than 25 percent of patients who could benefit from the procedure elect to receive it."
Osteoarthritis of the hip is a progressive type of arthritis closely associated with aging and obesity. It affects about 10 million Americans, causing pain, decreased mobility and increased risk of falls and fractures.
Generally, non-surgical treatment is first recommended to reduce joint pain and inflammation and improve joint function. Hip replacements are performed when less invasive forms of treatment - medications and physical therapy - have failed.
"Osteoarthritis of the hip has a devastating impact on a patient's quality and length of life. Our study aimed to understand how total hip replacements affect tasks people do in their everyday lives, such as bathing, dressing, walking a few blocks, shopping and preparing meals," George said.
Patients who were disabled at the time of surgery had transitioned out of disability within one year of the procedure. Total hip replacement is an invasive treatment with a long rehabilitation period. According to Dr. George, this may help explain why physicians are less likely to present surgery as an option to those patients 85 years of age and older, and why there may be some reluctance among patients to choose the procedure.
"Physicians are less likely to present this option to the very old," George said, "but they should feel confident in recommending this procedure to those who are eligible for it."
"We know that hip replacements are relatively safe and reports have shown a very high rate of patient satisfaction due to reduced pain and increased range of motion," she added.
InHealth: The Institute for Health Technology Studies
Researchers found that total hip replacements provide a cost savings to the health care system because reimbursement for the procedure (averaging $4,000 - $6,000) proves less costly than the long-term cost of health care for the disabled.
In addition to improved quality of life, health economists estimate savings associated with a year of a disability-free life at approximately $50,000, including all related health-care costs incurred by disabled patients such as hospital stays, nursing homes and home health care.
"We found that total hip arthroplasty improves everyday life for patients and is as beneficial to people in their 80s or 90s as it is for someone in their 60s," said Linda George, Ph.D., professor of Sociology and associate director of the Duke Center for the Study of Aging.
"While the number of surgeries conducted in the U.S. has increased dramatically over the last decade, fewer than 25 percent of patients who could benefit from the procedure elect to receive it."
Osteoarthritis of the hip is a progressive type of arthritis closely associated with aging and obesity. It affects about 10 million Americans, causing pain, decreased mobility and increased risk of falls and fractures.
Generally, non-surgical treatment is first recommended to reduce joint pain and inflammation and improve joint function. Hip replacements are performed when less invasive forms of treatment - medications and physical therapy - have failed.
"Osteoarthritis of the hip has a devastating impact on a patient's quality and length of life. Our study aimed to understand how total hip replacements affect tasks people do in their everyday lives, such as bathing, dressing, walking a few blocks, shopping and preparing meals," George said.
Patients who were disabled at the time of surgery had transitioned out of disability within one year of the procedure. Total hip replacement is an invasive treatment with a long rehabilitation period. According to Dr. George, this may help explain why physicians are less likely to present surgery as an option to those patients 85 years of age and older, and why there may be some reluctance among patients to choose the procedure.
"Physicians are less likely to present this option to the very old," George said, "but they should feel confident in recommending this procedure to those who are eligible for it."
"We know that hip replacements are relatively safe and reports have shown a very high rate of patient satisfaction due to reduced pain and increased range of motion," she added.
InHealth: The Institute for Health Technology Studies
Hip Replacement Current Events and Hip Replacement News RSSNovel surgery may help young trauma patients avoid total hip replacements
A novel surgery using transplanted bone and cartilage may help young patients avoid a hip replacement after a specific traumatic injury to the hip joint, according to a case study by orthopedic trauma specialists at Hospital for Special Surgery in New York. The study appears in the February issue of the Journal of Orthopaedic Trauma.
New study finds low mortality risk following knee and hip replacement
Total hip and total knee replacement surgeries are highly successful and very common procedures for people experiencing pain associated with degenerative joints.
Patients can safely skip pre-surgery stress tests and beta blockers
Physicians should "throttle back" from routinely ordering stress tests and prescribing beta blockers to patients before non-cardiac surgeries, according to a report by the University of Michigan released online this week.
Trimming US health care spending will require new approaches, study finds
Slowing the growth in U.S. health care spending will most likely require adoption of an array of strategies as well as an improved approach to moving promising strategies into widespread use, according to a new analysis by the RAND Corporation.
Study outlines strategies to test new payment models for health care
A new RAND Corporation study outlines methods that might be used to test a novel payment system for medical care that would provide doctors, hospitals and other health providers a set fee for treating an ailment such as hip replacement surgery.
Market based reforms have not harmed equity in the NHS, say researchers
Recent NHS reforms, such as the introduction of patient choice and provider competition, have not had a deleterious impact on equity with respect to waiting times for elective surgery in England.
Hip resurfacing is not for everyone
Hip resurfacing is often seen as a modern alternative to the more conventional total hip replacement, but new data from a study led by Rush University Medical Center suggest that a patient's age and gender are key to the operation's success.
How often do hip and knee replacements need revision?
A comprehensive study using nationwide data on hip and knee replacements in England has found that one in seventy-five patients require a revision of their joint replacement after three years.
UNC School of Pharmacy researchers create new synthetic heparin
Researchers at the University of North Carolina at Chapel Hill have patented a synthetic version of the drug heparin, called Recomparin, that is less complex chemically and should be easier to produce than previous forms.
Nanowire coating for bone implants, stents
University of Arkansas researchers have found a simple, inexpensive way to create a nanowire coating on the surface of biocompatible titanium that can be used to create more effective surfaces for hip replacement, dental reconstruction and vascular stenting.
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