OBJECTIVES:

The Comprehensive Care for Joint Replacement (CJR) Model from the Centers for Medicare and Medicaid Services make hospitals and healthcare systems more responsible for better clinical and economical outcomes of total hip arthroplasty (THA) aimed at slowing Medicare spending growth. Oxidized Zirconium^◊ (OxZr) implants have been shown in numerous registry and clinical studies to be clinically effective when used on elective THA. The objective of this study was to evaluate 30, 90 and 180- and one-year outcomes in hip replacement due to hip fracture for patients using OxZr implants compared to non-OxZr.

METHODS:

We retrospectively reviewed data from the Limited Data Set version of the Medicare Standard Analytic File– 100% sample. The inpatient and denominator files were used, and claims were linked based on the unique beneficiary identifier to track beneficiaries longitudinally. We used 1:1 propensity score matching on demographic characteristics including the Charlson Comorbidity Index. All-cause mortality and readmissions were computed for patients who had at least one year follow up data before 31 December 2021.

RESULTS:

We matched 1,274 OxZr and non-OxZr 1,274 patients. Patients treated with OxZr were 53% less likely to be readmitted compared to non-OxZr treated patients (odds ratio [OR] 0.47 p=0.0000, 47% OR 0.53 p=0.0000, 42% OR 0.58 p=0.0000 and 32% OR 0.68 p=0.0000 over 30, 90, 180 and 365 days respectively. For mortality, OxZr were 83% less likely die (OR 17 p=0.0000, 78% OR 0.22 p=0.0000, 77% OR 0.33 p=0.0000 and 72% OR 0.28 p=0.0000, over 30, 90, 180 and 365 days respectively compared to non-OxZr treated patients.

CONCLUSIONS:

Our study demonstrated that using OxZr compared to non-OxZr in THA patients due to hip fracture results in significantly reduced readmissions and mortality. These findings corroborate a growing body of evidence suggesting better clinical performance of OxZr in elective patient population.