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. 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 Oxidized Zirconium (OxZr) implants compared to metal-on-polyethylene (MoP).

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 MoP 1,274 patients. Patients treated with OxZr were 29% less likely to be readmitted compared to MoP treated patients (odds ratio [OR] 0.71 p=0.009, 22% OR 0.78 p=0.006, 19% OR 0.58 p=0.004 and 13% OR 0.87 p=0.012 over 30, 90, 180 and 365 days respectively. For mortality, OxZr were 33% less likely die (OR 67 p=0.12, 29% OR 71 p=0.04, 32% OR 0.68 p=0.005 and 17% OR 0.83 p=0.10, over 30, 90, 180 and 365 days respectively compared to MoP treated patients.

CONCLUSIONS:

Using real-world data, our study demonstrated that the use of OxZr compared to MoP in THA patients due to hip fracture results in significantly reduced readmissions and mortality. We suggest further studies to assess if this translates to reductions in revisions and therefore cost overall.