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dc.contributor.authorNandi, Sumon
dc.contributor.authorSchwarzkopf, Ran
dc.contributor.authorChen, Antonia
dc.contributor.authorSeyler, Thorsten
dc.contributor.authorWheeler, Lauren
dc.contributor.authorParvizi, Javad
dc.contributor.authorAdelani, Muyibat A.
dc.contributor.authorBrown, Timothy S.
dc.contributor.authorClohisy, John C.
dc.contributor.authorCourtney, Maxwell
dc.contributor.authorDietz, Matthew J.
dc.contributor.authorLevine, Brett R.
dc.contributor.authorMears, Simon C.
dc.contributor.authorOtero, Jesse E.
dc.contributor.authorSporer, Scott M.
dc.date.accessioned2022-05-23T11:16:14Z
dc.date.available2022-05-23T11:16:14Z
dc.date.issued2022-01-01
dc.identifier.urihttp://hdl.handle.net/10713/18961
dc.description.abstractBackground: There is considerable disparity in institutional practices surrounding routine pathologic examination of femoral heads removed during total hip arthroplasty (THA). Multiple groups have studied the merits of routine femoral head pathology in THA, without clear consensus. We sought to further investigate the existing evidence on routine pathologic examination of femoral heads retrieved during THA to determine if this practice provides additional clinical value and is cost-effective. Material and methods: To conduct a systematic review of the literature, a medical librarian was consulted to develop and perform comprehensive searches in PubMed (1809-present), Embase (embase.com 1974-present), CINAHL (EBSCO, 1937-present), and the Cochrane Central Register of Controlled Trials (Wiley). Final searches resulted in 727 references. Through multiple reviewer screenings and assessments of eligible full-text articles, we included 14 articles for review. Results: Our systematic review yielded pathologic examination results from 17,388 femoral head specimens collected during THA. In 0.85% of cases, the pathologic diagnosis differed in a meaningful way from the preoperative clinical diagnosis. Routine pathology changed patient management in approximately 0.0058% of cases. The average cost for pathologic examination of each specimen was $126.38. Conclusion: Routine pathologic examination of femoral heads retrieved during THA has limited impact on patient management. With an estimated 500,000 THAs performed in 2019, the economic feasibility of routine femoral head pathology is limited at an annual cost of up to $63,000,000 and cost per quality-adjusted life-year approaching infinity. However, surgeon discretion on a patient-specific or practice-specific basis should be used to make the final determination on the need for femoral head pathology.en_US
dc.description.urihttps://doi.org/10.1016/j.artd.2022.03.016en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofArthroplasty Todayen_US
dc.subjectArthroplastyen_US
dc.subjectCosten_US
dc.subjectFemoral headen_US
dc.subjectHipen_US
dc.subjectPathologyen_US
dc.subjectRoutineen_US
dc.titleRoutine Pathologic Examination of Femoral Head Specimens from Total Hip Arthroplasty May Not Be Indicated or Cost-effective: A Systematic Reviewen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.artd.2022.03.016
dc.source.journaltitleArthroplasty Today


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