Metal-on-metal resurfacing and the cost to the nation: A conservative estimate of the unexpected costs required to implement the new metal-on-metal follow-up programme in the UK

This source preferred by Tom Wainwright

Authors: Lloyd, J., Wainwright, T. and Middleton, R.

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Authors: Lloyd, J., Starks, I., Wainwright, T. and Middleton, R.

© 2013 EFORT. All rights are reserved. Introduction: Metal-on-metal hip resurfacings (HR) have been widely used over the last 10 years due to their perceived advantages in younger active individuals. However, concerns over the use of metal-on-metal articulations, following the withdrawal of the ASR (DePuy Orthopaedics Inc., Warsaw, Indiana), have led the British Orthopaedic Association (BOA)/British Hip Society (BHS) to issue guidance on the long-term follow-up of these patients. Objective: Assess the cost implications of implementing the new surveillance guidelines in England and Wales. Design: Use the National Joint Registry (NJR) to calculate the number of HRs performed nationally since the start in 2003. Propose various follow-up protocols to calculate the financial cost of implementing the surveillance. Results: Between 2003 and 2010, a total of 39,267 hip resurfacing arthroplasties were recorded in the National Joint Registry (NJR). The cost of 10-year follow-up for these patients ranges from £98,247,680 to £195,703,040 dependent upon the follow-up protocol used. Conclusion: HR follow-up is five to ten times more expensive than following up a conventional total hip replacement. In a time of budget cuts, this has huge financial implications for the NHS.

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