Geert Peersman1, Wouter Jak2, Tom Vandenlangenbergh2, Christophe Jans2, Philippe Cartier3, Peter Fennema4. 1. Department of Orthopaedic Surgery, Ziekenhuis Netwerk Antwerp, Campus Stuivenberg, Belgium. Electronic address: geert.peersman@telenet.be. 2. Department of Orthopaedic Surgery, Ziekenhuis Netwerk Antwerp, Campus Stuivenberg, Belgium. 3. Institut du Genou, Clinique Hartmann, Neuilly sur Seine, Paris, France. 4. AMR Advanced Medical Research, 8708 Männedorf, Switzerland.
Abstract
BACKGROUND: Unicondylar knee arthroplasty (UKA) is believed to lead to less morbidity and enhanced functional outcomes when compared with total knee arthroplasty (TKA). Conversely, UKA is also associated with a higher revision risk than TKA. In order to further clarify the key differences between these separate procedures, the current study assessing the cost-effectiveness of UKA versus TKA was undertaken. METHODS: A state-transition Markov model was developed to compare the cost-effectiveness of UKA versus TKA for unicondylar osteoarthritis using a Belgian payer's perspective. The model was designed to include the possibility of two revision procedures. Model estimates were obtained through literature review and revision rates were based on registry data. Threshold analysis and probabilistic sensitivity analysis were performed to assess the model's robustness. RESULTS: UKA was associated with a cost reduction of €2,807 and a utility gain of 0.04 quality-adjusted life years in comparison with TKA. Analysis determined that the model is sensitive to clinical effectiveness, and that a marginal reduction in the clinical performance of UKA would lead to TKA being the more cost-effective solution. CONCLUSION: UKA yields clear advantages in terms of costs and marginal advantages in terms of health effects, in comparison with TKA.
BACKGROUND:Unicondylar knee arthroplasty (UKA) is believed to lead to less morbidity and enhanced functional outcomes when compared with total knee arthroplasty (TKA). Conversely, UKA is also associated with a higher revision risk than TKA. In order to further clarify the key differences between these separate procedures, the current study assessing the cost-effectiveness of UKA versus TKA was undertaken. METHODS: A state-transition Markov model was developed to compare the cost-effectiveness of UKA versus TKA for unicondylar osteoarthritis using a Belgian payer's perspective. The model was designed to include the possibility of two revision procedures. Model estimates were obtained through literature review and revision rates were based on registry data. Threshold analysis and probabilistic sensitivity analysis were performed to assess the model's robustness. RESULTS: UKA was associated with a cost reduction of €2,807 and a utility gain of 0.04 quality-adjusted life years in comparison with TKA. Analysis determined that the model is sensitive to clinical effectiveness, and that a marginal reduction in the clinical performance of UKA would lead to TKA being the more cost-effective solution. CONCLUSION: UKA yields clear advantages in terms of costs and marginal advantages in terms of health effects, in comparison with TKA.
Authors: Andrew J Porteous; James R A Smith; Rachel Bray; James R Robinson; Paul White; James R D Murray Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-01-27 Impact factor: 4.342
Authors: Edward Burn; Alexander D Liddle; Thomas W Hamilton; Sunil Pai; Hemant G Pandit; David W Murray; Rafael Pinedo-Villanueva Journal: Pharmacoecon Open Date: 2017-12
Authors: Edward Burn; Alexander D Liddle; Thomas W Hamilton; Andrew Judge; Hemant G Pandit; David W Murray; Rafael Pinedo-Villanueva Journal: BMJ Open Date: 2018-04-29 Impact factor: 2.692