HSS Study: Dual Mobility Implants Saves Money!

When it comes to dual mobility total hip replacements, is it another “solve one problem, create another”?

Researchers from Hospital for Special Surgery (HSS) and Weill Cornell Medical College, both in New York, have teamed up to examine if these popular devices are all that they are purported to be.

Their research, “The Cost-Effectiveness of Dual Mobility Implants for Primary Total Hip Arthroplasty: A Computer-Based Cost-Utility Model,” was published in the May 3, 2017 edition of The Journal of Bone & Joint Surgery.

Alexander McLawhorn, M.D., M.B.A., orthopedic surgeon at HSS, told OTW, “Dislocation after primary total hip arthroplasty is a common reason for hip replacement failure and reoperation. Dual mobility total hip replacements, which became FDA approved within the last decade, reduce the risk of dislocation, and they are being used with increasing frequency for primary total hip replacements in the United States.”

“However, these implants can cost more and introduce the possibility of unique failure mechanisms. Cost-effectiveness analysis is a useful tool for exploring costs and outcomes trade-offs between two competing treatments—in this case, total hip with conventional bearings and total hip with dual mobility bearings.”

“Our results underscored the cost of total hip dislocations to the health care system. Because these costs are so high, and because complications from dual mobility bearings appear to be quite low, dual mobility implants appear to be cost effective, even cost saving, in our exploratory model.”

“We also explored benchmarks for dual mobility performance. We were able to suggest complication rates at which dual mobility components would cease being cost-effective. These data are useful in terms of monitoring this relatively new bearing option.”

“We did not anticipate finding that dual mobility bearings could be cost-saving!”

“Again, this really underscores the cost of total hip dislocations to the health care system. Long term data on modern dual mobility bearing designs are needed to further substantiate our results. I personally would not recommend the routine use of dual mobility bearings in all patients. It is my personal practice to restrict their use to patients at elevated risk for postoperative dislocation.”