Cost-effectiveness Analysis of Three Treatment Modalities for Hip Osteoarthritis

Introduction: There are three prominent treatment modalities for canine hip dysplasia: conservative therapy, femoral head and neck excision (FHNE), and total hip replacement (THR). The purpose of this study was to calculate the lifetime cost-effectiveness of each modality. Our hypothesis was that FHNE would be the most cost effective.

Materials and Methods: Surgery costs of FHNE and THR were collected from 15 practices in eight U.S. cities. The literature was used to determine revision, explantation, and post-FHNE treatment cost. For conservative treatment, costs were calculated per day for a 35 kg dog using online pharmacy data. Inflation of 4.5% was used for all subsequent years.

Results: For dogs presenting with clinical signs between ages 1 and 8 years, FHNE had the lowest lifetime cost although THR cost was within $382 if performed at 1 year of age. THR had the second lowest lifetime cost until 5 years of age, after which point, the lifetime estimated cost of conservative management was less than THR. For dogs presenting after 8 years of age, conservative management was the most cost effective.

Discussion/Conclusion: Overall FHNE was the most cost-effective modality, confirming the hypothesis. However, conservative management became more cost-effective in the geriatric years. For dogs presenting with clinical signs at 9 to 12 months of age, THR may not be financially prohibitive if lifetime cost is considered. This study shows the utility of this type of analysis but should be refined as we improve the accuracy of the information used for the calculations.

Acknowledgement: There was no proprietary interest or funding provided for this project.

Publication History

Article published online:
26 October 2022