Do “Premium” Joint Implants Add Value?: Analysis of High Cost Joint Implants in a Community Registry
Open Access
- 1 January 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 469 (1), 48-54
- https://doi.org/10.1007/s11999-010-1436-z
Abstract
Numerous joint implant options of varying cost are available to the surgeon, but it is unclear whether more costly implants add value in terms of function or longevity. We evaluated registry survival of higher-cost “premium” knee and hip components compared to lower-priced standard components. Premium TKA components were defined as mobile-bearing designs, high-flexion designs, oxidized-zirconium designs, those including moderately crosslinked polyethylene inserts, or some combination. Premium THAs included ceramic-on-ceramic, metal-on-metal, and ceramic-on-highly crosslinked polyethylene designs. We compared 3462 standard TKAs to 2806 premium TKAs and 868 standard THAs to 1311 premium THAs using standard statistical methods. The cost of the premium implants was on average approximately $1000 higher than the standard implants. There was no difference in the cumulative revision rate at 7–8 years between premium and standard TKAs or THAs. In this time frame, premium implants did not demonstrate better survival than standard implants. Revision indications for TKA did not differ, and infection and instability remained contributors. Longer followup is necessary to demonstrate whether premium implants add value in younger patient groups. Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.Keywords
This publication has 39 references indexed in Scilit:
- Weight of Polyethylene Wear Particles is Similar in TKAs with Oxidized Zirconium and Cobalt-chrome ProsthesesClinical Orthopaedics and Related Research, 2010
- The Epidemiology of Revision Total Knee Arthroplasty in the United StatesClinical Orthopaedics and Related Research, 2010
- Comparison between highly cross-linked and conventional polyethylene in total knee arthroplastyThe Knee, 2009
- No Superiority of Cemented Metal-on-Metal vs Metal-on-Polyethylene THA at 5-Year Follow-upOrthopedics, 2009
- The low contact stress mobile-bearing total knee replacementThe Journal of Bone and Joint Surgery. British volume, 2009
- Excellent Survival of All-polyethylene Tibial Components in a Community Joint RegistryClinical Orthopaedics and Related Research, 2007
- Implant Selection and Cost for Total Joint ArthroplastyClinical Orthopaedics and Related Research, 2007
- Long-Term Results of Low Contact Stress Mobile-Bearing Total Knee ReplacementsClinical Orthopaedics and Related Research, 2003
- Mobile-Bearing Knee Replacement: Clinical ResultsClinical Orthopaedics and Related Research, 2001
- Poor outcome of 44 cemented total hip arthroplasties with alumina ceramic heads: Clinical evaluation and retrieval analysis after 10-16 yearsActa Orthopaedica, 2001