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3. Hospital Cost of Treating Early Dislocation following Hip Arthroplasty

Author

Roberto Procaccini, Mario Marinelli, Luigi de Palma, and Andrea Soccetti

Subjects
Male, Reoperation, medicine.medical_specialty, Arthroplasty, Replacement, Hip, medicine.medical_treatment, Osteoarthritis, Osteoarthritis, Hip, Postoperative Complications, Femur Head Necrosis, Hip replacement, medicine, Hip Dislocation, Humans, Orthopedics and Sports Medicine, Hospital Costs, Hip Dislocation, Congenital, Reduction (orthopedic surgery), Aged, Aged, 80 and over, Hip surgery, Hip Fractures, business.industry, Middle Aged, medicine.disease, Arthroplasty, Prosthesis Failure, Surgery, Hip arthroplasty, Female, Implant, business, Complication
Abstract

Dislocation is a frequent and costly complication of hip arthroplasty. The purpose of this study was to assess the financial impact on the treating institution of this complication in patients with primary hemiarthroplasty (HA), total hip arthroplasty (THA) and revision surgery (RTHA). Between October 2001 and August 2009, 2014 consecutive hip arthroplasties were performed at our institution, of which 87 (18 HA, 44 THA and 25 RTHA) dislocated within 6 weeks of the primary operation. The average cost of treating implant dislocation by closed reduction, open reduction or revision was assessed and expressed as a percentage cost increase compared to an uncomplicated procedure. Of the 87 dislocated implants all needed one or more closed reductions and 52 eventually required revision surgery. An early dislocation increased the cost of HA, THA and RTHA by 472%, 342% and 352%, respectively.

Published
2012
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4. Investigation of work-related disorders in truck drivers using RULA method

Author

A Pagnotta, C Masiero, F Greco, M Masali, M Massaccesi, and A. Soccetti

Subjects
Adult, Male, Automobile Driving, medicine.medical_specialty, Posture, Poison control, Physical Therapy, Sports Therapy and Rehabilitation, Human Factors and Ergonomics, Work related, Occupational safety and health, Musculoskeletal disorder, medicine, Humans, Safety, Risk, Reliability and Quality, Engineering (miscellaneous), Neck pain, business.industry, Incidence, medicine.disease, Spinal column, Trunk, Surgery, Occupational Diseases, medicine.anatomical_structure, Italy, Physical therapy, Spinal Diseases, medicine.symptom, business, Automobiles, human activities, Cervical vertebrae
Abstract

A high incidence of spinal disorders is observed in professional drivers; in particular, back and neck pain result in high rates of morbidity and low retirement age. A sample of 77 drivers, of rubbish-collection vehicles who sit in a standard posture and of road-washing vehicles, who drive with the neck and trunk flexed, bent and twisted, was studied using RULA, a method for the evaluation of the exposure to risk factors associated with work-related upper-limb disorders. Results showed a significant association between trunk and neck scores and all self-reported pains, aches or discomforts in the trunk or neck regions in all subjects. In particular, the neck score was significant in both postures, reflecting high loading of the neck. Significantly different posture scores were also recorded for drivers using an adjustable vs. a non-adjustable seat. In this first RULA study of the working posture of professional truck drivers, the method proved to be a suitable tool for the rapid evaluation of the loading of neck and trunk.

Published
2003
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5. Cost-effectiveness of cemented versus cementless total hip arthroplasty. A Markov decision analysis based on implant cost.

Author

M. Marinelli, A. Soccetti, N. Panfoli, L. de Palma, Marinelli, M, Soccetti, A, Panfoli, N, and de Palma, L

Subjects
TOTAL hip replacement, ARTIFICIAL hip joints, HIP surgery, MEDICAL technology, PROSTHETICS
Abstract

Background: Probabilistic decision analysis is a means of reflecting the uncertainty parameter in models and of presenting it in a comprehensible manner to decision-makers.Materials and Methods: A cost-effectiveness model was constructed to compare the cementless and cemented total hip prostheses implanted at our department in terms of lifetime costs and quality-adjusted life-years (QALY). Revision rates were obtained from the Orthopaedic Prosthesis Register of the Laboratory of Medical Technology, Istituti Ortopedici Rizzoli, Bologna, Italy.Results: The risk of early revision (at 5 years of follow-up) for cementless and cemented prostheses was 1.6% and 1.4%, respectively, resulting in equal QALY for the two implant types. Analysis of mean cost and QALY indicated that use of either implant is not associated with cost savings.Discussion: Management with cementless or cemented total hip prostheses in a theoretical cohort of 70-year-old patients with fracture of the femoral neck or arthritis involving the hip is not significantly different according to the probabilistic results from the model. [ABSTRACT FROM AUTHOR]

Published
2008
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6. Hospital cost of treating early dislocation following hip arthroplasty.

Author

de Palma, Luigi, Procaccini, Roberto, Soccetti, Andrea, and Marinelli, Mario

Subjects
COST effectiveness, HIP joint dislocation, HIP surgery, LENGTH of stay in hospitals, MEDICAL care costs, COMPLICATIONS of prosthesis, T-test (Statistics), TOTAL hip replacement, U-statistics, RETROSPECTIVE studies, DESCRIPTIVE statistics
Abstract

Dislocation is a frequent and costly complication of hip arthroplasty. The purpose of this study was to assess the financial impact on the treating institution of this complication in patients with primary hemiarthroplasty (HA), total hip arthroplasty (THA) and revision surgery (RTHA). Between October 2001 and August 2009, 2014 consecutive hip arthroplasties were performed at our institution, of which 87 (18 HA, 44 THA and 25 RTHA) dislocated within 6 weeks of the primary operation. The average cost of treating implant dislocation by closed reduction, open reduction or revision was assessed and expressed as a percentage cost increase compared to an uncomplicated procedure. Of the 87 dislocated implants all needed one or more closed reductions and 52 eventually required revision surgery. An early dislocation increased the cost of HA, THA and RTHA by 472%, 342% and 352%, respectively. [ABSTRACT FROM AUTHOR]

Published
2012
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