Background and Importance One of the most common orthopedic operations is the prosthetic replacement of the hip joint. To judge the choice of a prosthesis, we often lack factual data.
Aim and Objectives Our objective is to assess whether the recommendations of the High Health Security are respected and to analyse their average costs to optimise pharmaceutical validation by creating a prescription sheet for orthopedic implants.
Material and Methods Census of the various interventions was carried out during the year 2019 by type of act: Total Hip Prostheses (THP); Intermediate Prosthesis (IHP); Repeats (REP); Rebuilds (REB).
Analysis of the different friction couples (head/insert): Ceramic/polyethylene (C/PE); Metal/PE (M/PE); Ceramic/Ceramic (C/C).
The software used for data collection is ACCESS and for statistical analysis is SPSS.
Results 140 hip interventions in 2019 including: 34 HIP; 88 THP; 16 REP; 2 REB. Ages according to the type of operations carried out: 25.71% (≤50 years); 12.85% (50-70 years); 61.44% (≥70); with the distribution according to the type of prosthesis: THP (mean age 75 years); PIH (82 years); REP (47 years). Clinical indications were coxarthrosis 39.23% (THP); Femur fracture 14.28% (HIP, THP); Osteonecrosis 7.14% (THP); Rheumatoid arthritis 10.71% (IHP); Dislocation 17.81% (REP). Friction couples used were C/PE 3.57%; M/M 13.71%; C/C 82.72% distributed according to CLAS rating: competition (100% C/C), activity (78.7% C/C), leisure (80.8% M/PE), sedentary (100% M/PE). Breakdown of the average cost according to the allocated budget was 62.85% THP, 24.28% HIP, 8.57% REP, 1.42% REB.
Conclusion and Relevance The study showed that the most frequent interventions are IHP and THP, IHP are placed in very elderly patients in whom osteosynthesis is not possible, the C/C couple is reserved for people under the age of 50, with a level of activity and a life expectancy. Finally, we noticed that the most costly intervention is THP. Results are in accordance with the recommendations of the HAS. This study allowed us to create a prescription sheet from the analysis of these data indicating: identification of the patient specifying age and activity; clinical indication and type of prosthesis and friction. This procedure optimises the pharmaceutical validation by directing the clinician towards the right medical and pharmacoeconomic choice of the prosthesis.
Conflict of Interest No conflict of interest
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