Every year, around 18,000 older people in Sweden, mainly women, suffer a hip fracture. The cause is usually that the person has lost their balance and fallen.
About 2,000 people who break their femoral neck have their broken hip joint replaced with an artificial one, called a total hip replacement. But for about eight percent of patients, the new hip ball slips out of joint, which is very painful.
“Two joints in one”
In the new study, 779 patients received a new type of artificial hip joint. They were compared with 787 patients who received a standard model implant.
The result? One year after surgery, 33 patients (4.2 percent) with the standard prosthesis had suffered dislocation. Among those who received the new implant, only ten people (1.3 percent) were affected, a reduction of 70 percent.
A standard prosthesis consists of a metal ball enclosed in a plastic socket. The new model instead has two balls, a small metal ball that moves freely inside a larger plastic ball. The plastic ball can in turn move freely in a metal socket.
It's like two joints in one joint, says Nils Hailer, chief physician at Uppsala University Hospital and one of the people who led the study.
Twice as expensive
Most of the patients in the study underwent surgery at hospitals in Sweden and around 200 in the UK.
The price tag differs between healthcare regions, but roughly speaking, a standard prosthesis, including all components, costs about 10,000 kronor. The new model costs around 18,000.
In the group that received the new type of prosthesis, the risk of infections and other complications was also lower, according to the study.
The question is whether the benefits of the new prosthesis type justify the higher price. Health economists at the University of Oxford will now try to find out.
It is clear that hip implants of the new type are much more expensive in the UK than in Sweden, according to Nils Hailer.
Above all, advantages
For Sweden, it looks like it could be cost-effective, he says.
The average age of the patients in the study is 76. In eight to ten years, the researchers plan to follow up on how they are doing.
We will of course try to call those who are still alive and have the strength to show up for another follow-up, says Nils Hailer.
The study, published in the journal The Lancet, was conducted at 24 hospitals in the UK and 20 in Sweden. The Swedish hospitals are located in Borås, Eksjö, Danderyd, Gävle, Halmstad, Helsingborg, Kalmar, Karlskrona, Lidköping, Linköping, Ljungby, Lund, Nyköping, Skellefteå, Sunderby/Piteå, SU/Mölndal, Umeå, Uppsala, Västerås and Östersund.
The Swedish Research Council has funded the study with just over 15.5 million SEK.
The British equivalent, the National Institute for Health and Care Research, has contributed 433,000 pounds (equivalent to just over 5.5 million SEK).
Initially, 1,600 people were included in the study. 34 dropped out for various reasons, some because they withdrew their consent.
