The hip arthroplasty journey: where are we going and who is paying the bill?

Osteoarthritis (OA) is a leading cause of chronic disability worldwide with a substantial impact on healthcare economies.¹ The hip is the most commonly affected joint after the knee, and hip arthroplasty provides a low-morbidity, cost-effective solution to the pain and functional impairment arising from the disease.² The long-term survivorship of these prostheses is also generally good.³

So, where is the problem? The answer lies, at least in part, on the cumulative cost of the disease and its treatment on the economy. The lifetime risk of hip arthroplasty in western countries in 2013 was approximately 10%, and this continues to increase.⁴ In 2017, the number of hip arthroplasties reported to the National Joint Registry for England, Wales, and Northern Ireland was 105 306. The current standard NHS tariff payment for a non-complex hip arthroplasty is approximately £6000. This equates to a direct treatment cost in this territory alone of more than £530 million per annum. This does not, however, include the overall economic cost, which for OA as a whole is estimated at 1% of annual gross national product, costing the United Kingdom economy £3.2 billion in lost production.