A recent study found that global follow-up guidelines lack the ability to detect adverse reaction metal debris lesions after metal-on-metal hip arthroplasty and they are not cost effective or evidence-based.
Researchers compared follow-up guidelines for metal-on-metal (MoM) hip arthroplasty from five worldwide authorities worldwide, including the U.K. Medical and Healthcare Products Regulatory Agency (MHRA), European Federation of National Associations of Orthopaedics and Traumatology (EFORT), the U.S. Food and Drug Administration, Therapeutic Goods Administration of Australia and Health Canada. They assessed the guidelines for published evidence and their financial implications of hip resurfacing and total hip arthroplasties.
Findings showed large differences among the authorities in cost per patients. U.S. costs were three-times more than MHRA costs, for example. A large population survey showed a very large difference in costs between authorities, with the most costly protocol for surveillance of all symptomatic MoM arthroplasty patients being the FDA. The cheapest annual follow-up guidance was from MHRA, the data showed. The FDA and EFORT follow-up was three times more costly to perform.
Australia guidelines were about six-times more costly than the United States and Canada for asymptomatic patients. Of all the authorities, the EFORT guidelines were most expensive when recent data were used to classify a large amount of resurfaced hips as asymptomatic, the study showed.