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Hip Replacement Improves Function, Saves Money, at Any Age

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Duke Health News 919-660-1306

(DURHAM, NC) – Seniors with osteoarthritis who undergo total
hip replacement are twice as likely as those who do not to show
improvements in physical functioning and increased ability to
care for themselves, according to researchers at Duke
University Medical Center. The study, which is the largest of
its kind conducted to date, found that there is no age limit on
the benefits of hip replacement for patients.

Researchers found that total hip replacements provide a cost
savings to the health care system because reimbursement for the
procedure (averaging $4,000 - $6,000) proves less costly than
the long-term cost of health care for the disabled.

In addition to improved quality of life, health economists
estimate savings associated with a year of a disability-free
life at approximately $50,000, including all related
health-care costs incurred by disabled patients such as
hospital stays, nursing homes and home health care.

"We found that total hip arthroplasty improves everyday life
for patients and is as beneficial to people in their 80s or 90s
as it is for someone in their 60s," said Linda George, Ph.D.,
professor of Sociology and associate director of the Duke
Center for the Study of Aging. "While the number of surgeries
conducted in the U.S. has increased dramatically over the last
decade, fewer than 25 percent of patients who could benefit
from the procedure elect to receive it."

Osteoarthritis of the hip is a progressive type of arthritis
closely associated with aging and obesity. It affects about 10
million Americans, causing pain, decreased mobility and
increased risk of falls and fractures. Generally, non-surgical
treatment is first recommended to reduce joint pain and
inflammation and improve joint function. Hip replacements are
performed when less invasive forms of treatment -– medications
and physical therapy –- have failed.

"Osteoarthritis of the hip has a devastating impact on a
patient's quality and length of life. Our study aimed to
understand how total hip replacements affect tasks people do in
their everyday lives, such as bathing, dressing, walking a few
blocks, shopping and preparing meals," George said.

Patients who were disabled at the time of surgery had
transitioned out of disability within one year of the
procedure.

Total hip replacement is an invasive treatment with a long
rehabilitation period. According to Dr. George, this may help
explain why physicians are less likely to present surgery as an
option to those patients 85 years of age and older, and why
there may be some reluctance among patients to choose the
procedure.

"Physicians are less likely to present this option to the
very old," George said, "but they should feel confident in
recommending this procedure to those who are eligible for
it."

"We know that hip replacements are relatively safe and
reports have shown a very high rate of patient satisfaction due
to reduced pain and increased range of motion," she added.

The study, published in the June issue of the Journal of the
American Geriatrics Society, examined data from the Medicare
Current Beneficiary Survey –- a randomly selected group of
Medicare beneficiaries who represent 96 percent of the U.S.
population aged 65 and older –- from 1992 to 2003. Health data
from 131 patients who received total hip replacement were
compared to data from 257 patients who also had osteoarthritis
of the hip but did not receive hip replacement surgery.
Patients were interviewed three times each year for four
years.

The research was supported by a grant from The Institute for
Health Technology Studies (InHealth). The co-authors of this
study are Frank Sloan, Ph.D. and David Ruiz, Jr., BS.

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