• H D Veldman, R T A L de Bot, I C Heyligers, BoymansT A E JTAEJMaastricht University Medical Center, dept. of Orthopaedics, Maastricht, The Netherlands., and M Hiligsmann.
• Zuyderland Medical Center, Dept. Of Orthopaedic Surgery and Traumatology, Heerlen, The Netherlands.
• Expert Rev Pharmacoecon Outcomes Res. 2021 Aug 1; 21 (4): 579-593.

AbstractBackground: This study aims to present an overview and critical appraisal of all previous studies comparing costs and outcomes of the different modes of fixation in total hip arthroplasty (THA). A secondary aim is to provide conclusions regarding the most cost-effective mode of implant fixation per gender and age-specific population in THA, based on high quality studies.Methods: A systematic search was conducted to identify cost-effectiveness analyses (CEAs) comparing different modes of implant fixation in THA. Analysis of results was done with solely CEAs that had a high methodological quality.Results: A total of 12 relevant studies were identified and presented, of which 5 were considered to have the methodological rigor for inclusion in the analysis of results. These studies found that either cemented or hybrid fixation was the most cost-effective implant fixation mode for most age- and gender-specific subgroups.Conclusion: Currently available well performed CEAs generally support the use of cemented and hybrid fixation for all age-groups relevant for THA and both genders. However, these findings were mainly based on a single database and depended on assumptions made in the studies' methodology. Issues discussed in this paper have to be considered and future work is needed.

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