Total hip replacement

NHS Centre for Reviews and Dissemination
Record ID 31999008317
Authors' objectives:

This report considers the research evidence on whether health care needs are being met, the effectiveness and cost-effectiveness of different types of total hip replacement (THR) surgery and suggests how this evidence can be used by purchasers, providers and policy makers to improve the quality of care.

Authors' recomendations: The rate of elective total hip replacement is increasing. Around 40,000 were carried out by the NHS in 1994/95 and a substantial number by the private sector. Total hip replacement is a highly cost-effective procedure, however outcomes vary across the country. Decision aids to identify patients suitable for referral for total hip replacement have been developed. A large number of hip prostheses are used in Britain widely differing in price. Very few of these have had proper long-term evaluation. The cheaper, standard cemented, implants such as the 'Charnley' and the 'Stanmore' have been the most thoroughly evaluated and have been shown to have the lowest long-term failure rates over 10 20 years follow-up. Purchasers and providers should promote the use of those prostheses which have been shown to perform best in long-term follow-up. New prostheses should only be used after they have been thoroughly evaluated or as part of a national coordinated study. There is some evidence that patients operated on by trainees and surgeons with low volume of activity have poorer outcomes. Purchasing 'lifetime hip care' rather than individual procedures may provide an incentive to promote quality.
Authors' methods: Systematic review
Project Status: Completed
Year Published: 1996
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Arthroplasty, Replacement, Hip
  • Costs and Cost Analysis
  • Hip Prosthesis
Organisation Name: University of York
Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,
Contact Name:
Contact Email:
Copyright: Centre for Reviews and Dissemination
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.