Real-world 2-year clinical and economic outcomes among patients receiving a medial collared, triple tapered primary hip system versus other implants for total hip arthroplasty.

OBJECTIVE: To evaluate real-world outcomes of patients receiving ACTISTM ,1 a medial collared, triple-tapered (MCTT) hip system vs. other implants, for primary total hip arthroplasty (THA).

METHODS: Patients with THA between 2016-2021 from Mercy Healthcare Systems-Orthopedics Database were evaluated. The primary outcome was the 2-year revision. Secondary outcomes included operating room (OR) time, length of stay (LOS), and discharge disposition. Fine Stratification and Weighting (FSW) controlled for baseline characteristic differences between ACTIS and other implant groups. Cox proportional regression evaluated the hazard ratio (HR) for revision.

RESULTS: Among 9,225 patients with 10,205 THAs (mean [SD] age 66.8 [11.3] years, 56.0% female), MCTT was implanted in 1,591 hips and other implants in 8,614 hips. The balanced cohort included all 10,205 procedures (54.2% female; age 65.5 [11.3]; 14.1% Elixhauser index ≥5; 84.5% MCTT, 82.2% other since 2018; obesity 43.6% MCTT, 43.0% other). Two-year revision was 0.9% for MCTT and 1.8% in other implants (p = 0.021). HR for revision MCTT vs. other was 0.53 (95% CI 0.30-0.92; p = 0.023). Mean (SD) OR time was 69.07 (18.93) minutes for MCTT, 83.69 (43.88) for other implants (p < 0.001). LOS was 1.99 (1.15) days for MCTT, 2.45 (2.91) for other implants (p < 0.001). MCTT patients were more likely to be discharged home (90.7% vs 33.8%, p < 0.001) and less likely to be discharged to skilled nursing facilities (SNF) (4.2% vs 9.6%, p < 0.001). One-year cost savings per patient with MCTT was projected at $2,342.

CONCLUSIONS: MCTT patients had fewer revisions, reduced OR time, shorter LOS, more home and less SNF discharge, leading to cost savings.