Total knee replacement is cost effective

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Total knee replacement (arthroplasty) appears to be a cost-effective procedure for older adults with advanced osteoarthritis in the US Medicare, revealed by researchers.

The new study published in the June 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

The procedure appears to be cost-effective across all patient risk groups, and appeared more costly and less effective in low-volume centers than in high-volume centers.

Approximately 12 percent of adults older than 60 have symptoms of knee osteoarthritis, and medical cost of osteoarthritis is estimated to range from $1,000 to $4,100 per person per year.

Total knee arthroplasty is a frequently performed and effective procedure that relieves pain and improves functional status in patients with end-stage knee osteoarthritis. Almost 500,000 total knee arthroplasties were performed in the United States in 2005 at a cost exceeding $11 billion. Projections indicate dramatic growth in the use of total knee arthroplasty over the next two decades.

Elena Losina, Ph.D., of Brigham and Women’s Hospital and the Boston University School of Public Health, and colleagues developed a computer simulation model and populated it with Medicare claims data and cost and outcomes data from national and multinational sources.

The main outcomes of the study are:

– Having a total knee arthroplasty increased life expectancy in osteoarthritis patients.

– In patients not receiving total knee arthroplasty, medical cost of osteoarthritis increased from $37,100 to $57,900 per person. It means, undergoing total knee arthroplasty isresulting in a cost-effectiveness of $18,300.

Therefore, total knee arthroplasty is a highly cost-effective procedure for the management of end-stage knee osteoarthritis compared with non-surgical treatments and is within the range of accepted cost-effectiveness for other musculoskeletal procedures, the authors note.

“Clinicians, patients and policy makers should consider the relative cost-effectiveness of total knee arthroplasty in making decisions about who should undergo total knee arthroplasty, where and when,” the authors conclude.

Source: Archives of Internal Medicine, USA

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