Hospital Healthcare Resource Utilization Outcomes Following Total Hip Arthroplasty with ACTIS™ Hip System and Accolade® II Femoral Hip System: A Comparative Analysis

Background The ACTIS™ Hip System (ACTIS), a cementless, medial collared, triple tapered hip system from DePuy Synthes was launched in the US in 2016. This study was designed to evaluate healthcare resource utilization and hospital costs, among patients who underwent total hip arthroplasty (THA) with ACTIS compared to the Accolade® II Femoral Hip System (Accolade II). Methods The PINC AI (PREMIER) Healthcare Database was used for analysis. Patients > 21 years of age, undergoing cementless THA from January 2016 to September 2023, and implanted with ACTIS or Accolade II, were identified. Primary outcomes included length of hospital stay and 90- and 365-day all-cause readmission. Secondary outcomes included hip revision, and all-cause and hip related revisit and readmission rates within 90- and 365-days and hip-related complications at 90 and 365 days. The exposure was the device type (ACTIS vs. Accolade II). Study variables included patient demographics, insurance type, comorbidities, and hospital characteristics. Cohorts were balanced using covariate balance propensity score method and generalized linear model was used to compute outcomes. Results 14,238 ACTIS and 17,578 Accolade II patients were included in the analysis. Balanced cohorts had an average age of 66 years, 57% were female, and 57% were Medicare recipients. Length of stay was significantly shorter for ACTIS (1.65 days vs. 1.93 days for control, p-value < 0.01). The 90-day all-cause readmission rate was 2.62% for ACTIS and 3.15% for Accolade II and the mean difference of 0.52% [0.13–0.92%] was significantly lower (p-value < 0.01) for ACTIS. The mean difference for 365-day all-cause readmission was also significantly lower for ACTIS (1.19% [0.53–1.84%], p-value < 0.01). The rates of hip-related complications, such as dislocation and deep infection were lower for the ACTIS compared to the Accolade II cohort, both at 90- and 365-day post-surgery. Total cost of care at 365-day follow-up was also lower for ACTIS compared to the Accolade II cohort. Conclusions The comparative analyses showed favorable outcomes for the ACTIS cohort in terms of shorter length of stay, fewer all-cause readmissions, fewer discharges to skilled nursing facility and lower cost at 365-day follow-up compared to Accolade II.