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Letters Mortality after hip replacement

Response to two recent BMJ papers on mortality after hip replacement: comparative modelling study

BMJ 2014; 348 doi: (Published 19 February 2014) Cite this as: BMJ 2014;348:g1506
  1. Ngianga-Bakwin Kandala, principal research fellow1,
  2. Martin Connock, senior research fellow1,
  3. Ruth Pulikottil-Jacob, research fellow1,
  4. Hema Mistry, assistant professor1,
  5. Paul Sutcliffe, associate professor1,
  6. Matthew Costa, professor of trauma and orthopaedics2,
  7. Aileen Clarke, professor of public health and health services research, director Warwick Evidence1
  1. 1Warwick Evidence, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
  2. 2Warwick Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, UK
  1. N-B.Kandala{at}

Two BMJ observational studies report increased survival of patients after metal-on-metal resurfacing versus cemented or uncemented total hip replacement.1 2 We considered the potential usefulness of these new estimates for lifetime cost effectiveness models, which necessitate extrapolation beyond observed data.3 Cost effectiveness models have assumed similar mortality irrespective of implanted device.4 5 6

McMinn and colleagues examined men under 55 years who received Birmingham hip resurfacing or cemented or uncemented hip replacements (mean age ~48 years).1 Kendal and …

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