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Monday, 10 April, 2000, 18:59 GMT 19:59 UK
Hip joint advice 'could save 8m'
Hip joints
Hip joints vary in price from 400 to 2,000
Clear standards on artificial hip joints have been set out for the NHS for the first time.

The guidelines from the National Institute for Clinical Excellence (NICE) are to be issued to all orthopaedic surgeons and NHS Trusts in England and Wales.



We are determined to tackle the postcode lottery of care and to ensure the best use of NHS resources

Department of Health
The institute said the guidance, if followed properly, could save the NHS 8m per year.

The body was asked to issue clear guidelines on the use of artificial hips in terms of which ones work best and represent value for money.

Its key recommendation was that surgeons should use artificial hip joints which can show they last for ten years or more in order to reduce the frequency of replacement operations.

Artificial hip joints are inserted surgically into the hip to replace diseased or damaged joints.

Approximately 35,000 operations are carried out on the NHS in England and 2,8000 in Wales every year, according to NICE.

Between 10-15% of these have to be repeated because the replacement hip has worn out or there was a problem following the operation.

Costs for such procedures vary between 1,200 and 9,000, with an average of 3,686, and individual prostheses can vary in price from 400 to around 2,000.

NICE found evidence that cemented artificial hips met the 10-year benchmark more than uncemented or hybrid types and produced the least pain and discomfort.

NICE went on to recommend that if a surgeon had to use a hip that did not meet the 10-year benchmark, it should be proven to last for a minimum of three years.

Further trials

The guidance also urges the NHS to encourage the establishment of a UK hip registry and further trials as well as establishing audit strategies to monitor the uptake of NICE guidelines.

The Department of Health today welcomed the new guidance which it described as "clear and authoritative" and confirmed the guidance had been issued to all orthopaedic surgeons and hospital trusts.

In a statement it said: "We are determined to tackle the postcode lottery of care and to ensure the best use of NHS resources.

"The NHS Purchasing and Supplies Agency of the Department of Health welcomes the opportunity to take on the role of collating and disseminating information about the performance of individual products.

"This is in conjunction with NICE's recommendation that wherever possible the NHS should use artificial hip joints that can show they last for ten years."

It also recognised the value of comprehensive local information on hip implants and confirmed proposals for a central information database were being studied.

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