Arostegui I, Quintana JM, Goenaga JL, Azkarate J, Echeverria Y, Gonzalez N, Vidaurreta I; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2000; 16: 392.

Research Unit, Hospital de Galdakao, Vizcaya, Spain

Objectives: The evidence supporting the use of the different fixation mechanism employed on total hip replacement (THR) interventions is weak, and considerable variation in their use is found. This study tries to develop explicit criteria to evaluate the use of the different mechanism used on patients with osteoarthritis. Methods: The appropriateness of the use of three different types of fixation mechanism was judged by explicit criteria developed using RAND methodology. A panel of nine orthopaedic surgeons rated 864 scenarios, including three different fixation mechanisms: cemented, non-cemented and hybrid. Eight variables were included in the algorithm to judge the appropriateness of the intervention and mechanism. Data from five public hospitals, all belonging to the same public system, were collected during one year. The explicit criteria were applied to 604 interventions of patients with a diagnosis of osteoarthritis that underwent THJR. Results: Of the 604 interventions, in 9 of them the algorithm was not applicable. From the other 595 interventions evaluated, 31.8% were judged appropriate, 47.4% uncertain, and 17.5% inappropriate. Non cemented were used more frequently (77.5) than cemented (17.5%) or hybrid (5.0%) mechanisms, though one hospital employed more frequently the cemented. There were differences among the five centres in the appropriateness rate, ranging from 15.2 to 37.6%. Within fixation mechanism techniques, there were also differences, being considered more appropriate the non-cemented (37.1%) than the cemented (13.5%) or hybrid (13.3%). These differences also remained when judging the use of fixation mechanism by hospital. Conclusions: In these five hospitals there was important variation in the use of the three fixation mechanisms. The appropriateness also varied from one hospital to another and from one mechanism to another. Due to the lack of supporting evidence of the bibliographic literature on the use of these important therapeutic tools, and the variation found, further studies are needed to clarify their effectiveness.

Publication Types:

• Meeting Abstracts

Keywords:

• Arthroplasty, Replacement, Hip
• Blood Coagulation Factors
• Bone Cements
• Carrier Proteins
• Cementation
• Hip
• Hip Prosthesis
• Hospitals, Public
• Humans
• Ischium
• Osteoarthritis
• RPL29 protein, human
• ST13 protein, human
• Tumor Suppressor Proteins
• surgery
• hsrmtgs

Other ID:

• GWHSR0000007

UI: 102271681

From Meeting Abstracts