Podmokly A; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2002; 18: abstract no. 245.

National Center for Quality Assessment in Health Care, Syrokomli 10, Crocow, agapodm@poczta.onet.pl

BACKGROUND/OBJECTIVES: The aim of our study was comparison effectiveness and cost-effectiveness different types of prosthesis currently used in Poland in primary total hip and knee replacement. METHODS: We were trying to assess effectiveness on the basis of two types of outcome measure available in the orthopaedic literature on total hip and knee replacement: 1.survival of the prosthesis (typically represented by survivorship analysis or revision rates); 2.prosthesis function in situ, which is measured typically by one of several standardized clinical hip and knee scoring system which includes symptomatic loosening, and radiographic definitions of possible failure, including osteolysis (bone loss), subsidence and migration of the components, and wear of materials.(surrogates). RESULTS: Revision rate/survivorship was reported differently in different studies and in this connection it was impossible to draw up a meta-analysis. On the basis of RCT studies, registers and observational studies with 5 years follow-up or more, we compare efficacy of prosthesis which are currently used in Poland. The majority of the best evidence studies concerned Charlney prosthesis which, as cemented design, show good survival results at 10-15 years. We also prepared a critical appraisal of literature which indicates a influence of surrogates on revision of hip and knee prosthesis. Major an influence on revision of hip prosthesis has: aseptic loosening of stems (167), infections (37), dislocations (12) and fracture (9). Major an influence on revision of knee prosthesis has: wear of polyethylene (26), mechanical loosening of components (17), fracture (12). We collected direct and indirect costs connected with primary hip and knee alloplasty and revision surgery which are curry out in Poland hospitals, to prepare cost-effectiveness analysis. In accordance with our assessment non-cemented alloplasty is the cheapest method of implantation total hip and knee replacement. Econometric model showed that cost of cemented implementation in a 20 years period is cheaper than non-cemented cost of alloplasty. DISCUSSION: There is lack of evidence concerned many of prosthesis used in Poland in primary total hip and knee replacement.

Publication Types:

• Meeting Abstracts

Keywords:

• Animals
• Arthroplasty, Replacement, Hip
• Arthroplasty, Replacement, Knee
• Bone Cements
• Cementation
• Hip Prosthesis
• Knee Prosthesis
• Poland
• Polyethylene
• Prostheses and Implants
• ST13 protein, human
• Tumor Suppressor Proteins
• surgery
• hsrmtgs

Other ID:

• GWHSR0003182

UI: 102274861

From Meeting Abstracts