Hip Replacement Reduces Heart Failure, Depression and Diabetes Risk

     Hip Replacement Reduces Heart Failure, Depression and Diabetes Risk

PR Newswire

CHICAGO, March 22, 2013

Study supports the value of THR in aiding long-term health at minimal cost

CHICAGO, March 22, 2013 /PRNewswire-USNewswire/ --In addition to improving
life quality and diminishing pain, total hip replacement (THR) is associated
with reduced mortality, heart failure, depression and diabetes rates in
Medicare patients with osteoarthritis, according to a new study presented
today at the 2013 Annual Meeting of the American Academy of Orthopaedic
Surgeons (AAOS). The procedure also is cost effective with the 7-year costs
of THR only $6,366 higher than the cost of treating an osteoarthritis patient
for hip pain without THR.

"The study has demonstrated that THR confers a potential long-term benefit in
terms of prolonged lifespan and reduced burden of disease in Medicare patients
with osteoarthritis of the hip," said lead study author Scott Lovald, Ph.D., a
researcher at Exponent, Inc.

While the short-term benefits of THR are well known and documented, less
information exists on the long-term effects, cost and value of the surgery.

Using Medicare codes, researchers identified more than 43,000 patients with
osteoarthritis of the hip from 1998 to 2009. These patients were divided into
two groups – those receiving THR and those not receiving THR. The researchers
followed all of the patients for at least one year, and nearly 24,000 for
seven years, looking at annual Medicare payments, mortality, and new diagnoses
of congestive heart failure, ischemic heart disease, artherosclerosis
(hardening and narrowing of the arteries), diabetes and depression. The data
was adjusted for differences in age, sex, race, buy-in status, region and
Charlson score (standard quantification of the number and severity of
comorbidities a patient presents with).

Among the results:

  oThe THR patients had a consistently lower mortality risk – less than 52
    percent of that in the non-THR group.
  oHeart failure was similar between groups in the first year, but there was
    a consistent reduced risk (risk was between.85 and .92 of the risk for the
    non-THR group) at 3-to-7 years following surgery.
  oTHR patients had a reduced risk of diabetes at one and three years.
  oTHR patients had a reduced rate of depression starting at three years post
    THR surgery.

The THR patients in the study did have an increased risk of ischemic heart
disease and atherosclerosis at one year, and an increased risk of
"cardiovascular disease unspecified" over all time points.

The seven-year cumulative average Medicare payment for all medical care was
$82,788 for non-THR patients and $89,154 for THR patients, for a difference of
$6,366. The actual average per-patient THR cost is expected to be much less
than $6,366 when differences in costs incurred due to prescription pain
medications are taken into account.

"Joint (replacement) has been proposed as possibly cost-saving in the
management of disability related to arthritis," said Lovald. "This study
provides supporting data to evaluate the cost-effectiveness of THR."

View disclosure statement for Scott Lovald, Ph.D.

Study abstract

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SOURCE American Academy of Orthopaedic Surgeons

Website: http://www.aaos.org
Contact: Kristina Goel, +1-847-384-4034, or +1-312-388-5241, goel@aaos.org, or
Lauren Pearson Riley, +1-847-384-4031, +1-708-227-1773, pearson@aaos.org
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