Cost Effectiveness of Minimally Invasive Total Hip Arthroplasty

A study was conducted to compare three surgical techniques and to evaluate cost effectiveness in a population of 591 patients at 10 U.S. hospitals between 2002 and 2005. We evaluated costs, in U.S. dollars, and effectiveness, in quality-adjusted life days (QALYs), during the first 6 postoperative weeks, the period during which the most dramatic benefits of minimally invasive total hip arthroplasty (THA) were expected. Compared with the conventional technique at 6 weeks postoperatively, incremental savings were $5620 for the minimally invasive (MIS) two-incision hip procedure and $5089 for the mini-incision technique, and incremental effectiveness values were 0.037 QALYs (13.51 quality-adjusted life days) for the MIS two-incision hip procedure and 0.023 QALYs (8.40 quality-adjusted life days) for the mini-incision technique. A similar pattern in improvements was observed for time able to walk without support, hospital length of stay, and postoperative rehabilitation; the most substantial patient-valued outcomes were associated with the MIS two-incision hip procedure.