Cost Analysis of Dual-Mobility Versus Large Femoral Head Constructs in Revision Total Hip Arthroplasty

Matthew P. Abdel, Larry E. Miller, Arlen D. Hanssen, Mark W. Pagnano

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: The purpose of this study is to report healthcare payer costs of dual-mobility (DM) and large femoral head (LFH) constructs in revision total hip arthroplasties (THAs). Methods: A Markov model was constructed to analyze costs of re-interventions incurred by Medicare and private payers over a 3-year time horizon in patients who underwent unilateral revision THA with DM (n = 126) or LFH (n = 176) implants. Model states and probabilities were derived from prospectively collected registry data. Medicare costs were estimated as the weighted-average national Medicare payment for revision THA. Private payer costs were estimated by using a multiplier of Medicare costs. Results: Over a 3-year period following revision THA, re-interventions were performed in 11 (9%) DM patients and 34 (19%) LFH patients, costing $263-$1898 in DM THAs and $1285-$3946 in LFH THAs for Medicare. When compared to LFH implants, DM constructs were less costly to Medicare and private payers, resulting in cost differentials of $1536 and $2611, respectively. Conclusions: At mid-term follow-up, DM constructs utilized in revision THAs were associated with 11% lower absolute risk of re-intervention and payer savings of $1500-$2500 per case when compared to LFH constructs. Level of Evidence: Economic and decision analysis, Level III.

Original languageEnglish (US)
Pages (from-to)260-264
Number of pages5
JournalJournal of Arthroplasty
Issue number2
StatePublished - Feb 2019


  • cost
  • dislocation
  • dual-mobility constructs
  • instability
  • large femoral heads
  • total hip arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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