EP9.3 Cost-utility analysis of Periacetabular Osteotomy with and without arthroscopic management in patients with hip dysplasia: A trial-based economic evaluation

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ID: 331235
2026
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Abstract
Abstract Objective To assess the cost-effectiveness of hip arthroscopy at the time of periacetabular osteotomy (PAO) compared to PAO alone for patients with symptomatic hip dysplasia. Methods We conducted a trial-based economic evaluation using data from a multicentre randomized controlled trial comparing PAO plus arthroscopy with PAO in the management of symptomatic hip dysplasia in patients younger than 50 years of age. Effectiveness was measured as quality-adjusted life-years (QALYs), derived from the PROMIS-Preference scoring system. Health care utilization and clinical outcomes were derived from trial data. Missing data were handled using multiple imputation by chained equations, and seemingly unrelated regressions were used to adjust for baseline characteristics. Uncertainty around incremental costs and effectiveness was estimated using non-parametric bootstrapping. A scenario analysis was conducted using a societal perspective by incorporating productivity loss. Results Sixty-two patients had PAO plus arthroscopy and 55 patients had PAO alone. Mean age was 27.9 years (SD=8.14), and 84% were female. The PAO plus arthroscopy was associated with an additional cost of $5,822 (95% CI $3,070, $8,574) and fewer QALYs of -0.04 (95%CI -0.13, 0.05). The probability that PAO plus arthroscopy was cost-effective was 0% at the willingness-to-pay value of $50,000 per QALY. Findings were consistent from a societal perspective, in which PAO plus arthroscopy remained more costly ($4,950) and less effective (-0.03 QALYs loss). Conclusions Adding arthroscopy to PAO increased costs and did not improve health outcomes. From both healthcare and societal perspectives, PAO plus arthroscopy was not cost-effective, suggesting its use in the management of symptomatic hip dysplasia should be the exception.
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Authors Lisa Masucci, Stéphane Poitras, John C. F. Clohisy, Reza Ojaghi, Ariane Parisien, Kednapa Thavorn, Paul Beaulé
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.484
URL
https://doi.org/10.1093/jhps/hnag043.484
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