Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA.
J Arthroplasty. 2012 Sep;27(8 Suppl):66-71.e1. doi: 10.1016/j.arth.2012.03.046. Epub 2012 Jun 6.
We analyzed the effect of the Australian National Joint Registry on the cost of joint arthroplasty through identification of implants with higher than expected failure rates. From 2003 to 2007, 242,454 primary joint arthroplasties were performed in Australia at a total cost of $4.1 billion. Of these cases, 19,224 were performed using components identified by the Registry as poorly performing. If all of these cases were performed using average-performing designs, the number of revisions would have dropped by 28.6%. We also predicted that over a 5-year period after Registry identification, 32,807 primary procedures would be performed using poorly performing implants. If implants of average longevity were selected instead, we predict that 25.8% fewer revision procedures would be needed, ranging from 7% in unicompartmental knee replacement to 47% in total hip arthroplasty. This change in practice is expected to save 10.2% of direct costs, corresponding to $14 million over a 5-year period.
我们通过识别失败率高于预期的植入物来分析澳大利亚国家关节登记处对关节置换手术成本的影响。2003 年至 2007 年，澳大利亚共进行了 242454 例初次关节置换手术，总费用为 41 亿美元。其中，有 19224 例使用了登记处认定为性能不佳的组件。如果所有这些病例都使用性能平均的设计，翻修数量将减少 28.6%。我们还预测，在登记处发现后的 5 年内，将有 32807 例初次手术使用性能不佳的植入物。如果选择平均寿命的植入物，我们预计需要减少 25.8%的翻修手术，从单髁膝关节置换术的 7%到全髋关节置换术的 47%不等。这种治疗方式的改变预计将节省 10.2%的直接成本，在 5 年内相当于节省 1400 万美元。
