OBJECTIVES:

The Comprehensive Care for Joint Replacement (CJR) Model from the Centers for Medicare and Medicaid Services and similar programs from other payers 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 ceramic-on-polyethylene (CoP) implants.

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 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 ceramic-on-polyethylene 1,274 patients. Patients treated with OxZr were 24% less likely to be readmitted compared to CoP treated patients (odds ratio [OR] 0.76 p=0.04, 19% OR 0.81 p=0.012, 14% OR 0.86 p=0.04 and 3% OR 0.97 p=0.61 over 30, 90, 180 and 365 days respectively.

CONCLUSIONS:

Using real-world data, our study demonstrated that the use of OxZr compared to ceramic-on-polyethylene implants in THA due to hip fracture patients results in significantly reduced readmissions. Additional data is needed to assess if this translates to reductions in revisions and therefore cost overall.