How much does saving femoral head cost after acetabular fracture? Comparison between ORIF and THA


acetabular fracture ; costs efficacy ; open reduction and internal fixation ; quality of life ; total hip arthroplasty

Published online: Dec 31 2019

Alessandro Aprato, Cristina Ghia, Ferdinando Tosto, Luigi Sabatini, Alessandro Bistolfi, Alessandro Masse

From the Orthopaedic Department, University of Turin, Italy


We performed a prospective study on patients with acetabular fractures treated either with internal fixation either with arthroplasty comparing clinical outcomes, quality of life, economic resources and cost efficacy in the first five years after surgery.

Demographic data, diagnosis, index treatment, costs and subsequent surgeries were recorded. Patients were requested to fulfill Merle d’Aubigné and EQ-5D-5L questionnaires.

Clinical differences between treatments are significant only in discharge period. Comparing respectively group with fixation and arthroplasty, cost efficacy was 5483 and 10838 euros/quality-adjusted-life years, mean global costs 23965 and 16878 € and quality of life gained in five years 2.788 and 3.175.

Group of arthroplasty showed better quality of life at discharge and at one year. If choice between fixation and arthroplasty should be based only on cost-efficacy, arthroplasty should be suggested but clinical outcomes suggest to consider fixation because results at five years are not different to arthroplasty.