The authors hypothesized that unplanned readmissions, which are often caused by infections and dislocation, may be reduced with ceramic bearing usage. They also sought to confirm that the readmission rates for ceramic bearings were associated with the year of surgery. The authors also found that C-PE bearings were associated with significantly reduced readmission risk relative to M-PE at 30 days (hazard ratio [HR]: 0.91, p <ā0.001) and 90 days (HR: 0.93, pā<ā0.001). In terms of strength of association with 90-day readmission, however, it was ranked the ninth most associated independent factor. To the authors' knowledge, this is the first study to demonstrate an association between THA implant characteristics (in this case C-PE bearing usage) and reduced readmission rates in this context along with patient- and clinical-related factors. The readmission rates for COC were found to be comparable to M-PE.
The purpose of this study was to analyze whether the cost for ceramic-on-polyethylene (C-PE) and ceramic-on-ceramic (COC) bearings used in primary total hip arthroplasty was changing over time, and if the cost differential between ceramic bearings and metal-on-polyethylene (M-PE) bearings was approaching the previously published tipping point for cost-effectiveness of $325. Patient and clinical factors had a far greater impact on the cost of inpatient THA surgery than bearing selection. Because we found that costs and cost differentials for ceramic bearings were decreasing over time, and approaching the tipping point, it is likely that the cost-effectiveness thresholds relative to M-PE are likewise changing over time and should be revisited in light of the present study.