Determining Cost-Effectiveness of Total Hip and Knee Arthroplasty Using the Short Form-6D Utility Measure

Elmallah, Randa K.; Chughtai, Morad; Khlopas, Anton; Bhowmik-Stoker, Manoshi; Bozic, Kevin J.; Kurtz, Steven M.; Mont, Michael A.

doi:10.1016/j.arth.2016.08.006

Cited by 47 publications

(53 citation statements)

References 22 publications

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“…Total hip arthroplasty (THA) is a highly efficacious treatment for patients with hip osteoarthritis (HOA) [1][2][3]. Despite the success of THA, mechanical complications such as instability and aseptic loosening still occur and are often the result of implant malpositioning or sizing mismatch [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Trends and patient factors associated with technology-assisted total hip arthroplasty in the United States from 2005 to 2014

et al. 2020

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Background: Technology-assisted total hip arthroplasty (TA-THA) using either computer-assisted navigation or robotic assistance has become increasingly more popular. The purpose of this study was to examine the trends and patient factors associated with TA-THA. Methods: This is a retrospective review utilizing the National Inpatient Sample, a large national database incorporating inpatient hospitalization information. International Classification of Diseases, 9th Revision codes were used to identify patients with hip osteoarthritis who underwent primary total hip arthroplasty (THA). Patients were then separated into those who underwent TA-THA or conventional THA. Outcomes of interest included annual TA-THA utilization; patient and hospital characteristics associated with TA-THA; and trends for length of stay (LOS), cost, and discharge to home. Results: From 2005 to 2014, a total of 2,588,304 patients with hip osteoarthritis who underwent THA were identified in the National Inpatient Sample database. Of those, 39,700 (1.5%) underwent TA-THA. The number of TA-THA procedures increased from 178 (0.1% of all THA) in 2005 to 10,045 (3.0% of all THA) in 2014, which represented a 30-fold increase in incidence (P-trend <.0001). TA-THA was associated with Hispanic race, higher patient income, and the Western region of the United States. During the study period, there was a trend toward decreased LOS and increased discharge to home for both TA-THA and conventional THA. TA-THA was associated with higher inpatient cost. Conclusion: TA-THA is being increasingly used in the United States and is associated with specific patient factors. However, the value of TA-THA compared to conventional THA remains unclear and should be assessed with future research. Level of Evidence: III (retrospective cohort study).

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Section: Introductionmentioning

confidence: 99%

Trends and patient factors associated with technology-assisted total hip arthroplasty in the United States from 2005 to 2014

et al. 2020

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“…It can be assumed, that the known cost-effectiveness of THA gets stronger when the revision rate decreases [24,25].…”

Section: Discussionmentioning

confidence: 99%

Straight stem and threaded cup total hip arthroplasty systems in patients under 60 years of age: outdated or still a benchmark? A report on a cohort of 75 patients after 28.8-30.2 years of follow-up

Pisecky

Allerstorfer

Schauer

et al. 2020

Preprint

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Purpose: The goal of this retrospective observational study of one cohort was to evaluate the long-term outcome in patients younger than 60 years after total hip arthroplasty using a straight uncemented stem and an uncemented threaded cup. Methods: Between 1986 and 1987, 75 hips of 75 patients (mean age: 53.35±6.17 years) were consecutively implanted with an Alloclassic Zweymüller/Alloclassic SL stem and an Alloclassic CSF cup. 44 patients had died over the last 30 years. The remaining 31 patients (mean age: 82.9±6.4years) were reinvited for follow-up examinations. Clinical and radiographic evaluations were carried out. Results: At a mean follow-up of 29.5 (28.8-30.2), 4 patients (5.3%) were lost to follow up. For the endpoint aseptic loosening (defined as the removal of stem or the cup for 2 cases), the overall survival rate is 97.3%. For the endpoint revision for any reason (22 patients), the survival rate is 70.6%. Eleven patients needed an exchange of head and liner due to wear. The mean time from implantation until change of head and liner was 21.44 years (SD 5.92). Other reasons for revisons were septic loosenings (3 cases), aseptic loosening of stem and cup (1 case), aseptic loosening of stem (1 case), periprosthetic calcification (2 cases), implant fracture (1 case), periprosthetic fracture (1 case), intraoperative fissure of stem (1 case), total wear of liner including cup (1 case). Conclusion: The combination of a straight stem (Alloclassic) and a screw cup (CSF) shows excellent results in young patients under the age of 60 at ultra-longterm follow up at 30 years. Revisions due to wear of the polyethylene liner are more likely than in the older patients.

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“…Besides, the rising number of arthroplasty procedures, corresponding with an increased yearly cost, will result in a huge economic burden for both the families and the health care system [2,[7][8][9][10]. As China's healthcare expenditures are soaring [11], the government has sought to reduce the overall cost of arthroplasty procedures by shortening average LOS, strengthening the supervision of surgical procedures and management of purchasing medical disposable materials.…”

Section: Introductionmentioning

confidence: 99%

Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients

Hou

Zhang

et al. 2020

Preprint

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Background: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are required for many patients. No recent studies that concentrate on the costs for each of the payment items both for TKA and THA when comparing simultaneous bilateral procedures with staged arthroplasty. This study aimed to evaluate the medical costs, length of stay(LOS), blood transfusion, and in-hospital complications in patients undergoing simultaneous TKA or THA and staged TKA or THA. Methods: A retrospective cohort study was conducted by analyzing 1,579 patients from a single institution. All patients who underwent primary bilateral TKA or THA from 2013 to 2018 were divided into three groups: TKA,THA and all patients. Then, we grouping simultaneous bilateral groups and staged bilateral groups in these three groups respectively. Finally, these two sub-groups(simultaneous bilateral groups and staged bilateral groups) were compared between the three groups(TKA, THA, and pooled groups). Results: All categories of medical costs, except for materials fees which were higher in the simultaneous bilateral THA and pooled groups but with no statistical significance, were lower in the simultaneous TKA, THA and pooled simultaneous groups. The total average medical costs in simultaneous and staged bilateral TKA groups were $15,535.621and $16,747.192, p <0.001), respectively; THA groups were $15,046.210 and $16,126.808, ( p =0.003), respectively; pooled groups were $16,506.971and $15,467.561, ( p <0.001), respectively. All costs were presented in the United States dollar. The highest and lowest costs were materials fees and nursing care fees. No significant differences were found for five common co- morbidities and postoperative complications between the two sub-groups in three groups. The simultaneous groups had a shorter LOS, a higher incidence of blood transfusion than staged groups whether it is TKA groups or THA or pooled groups. Conclusions: These results indicate that simultaneous bilateral TKA and THA with a shorter LOS is more economical than staged bilateral TKA and THA. Counts of complications were not affected by the choice for staged or simultaneous bilateral total arthroplasty. But blood transfusion was more prevalent in the simultaneous groups both for TKA and THA.

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Determining Cost-Effectiveness of Total Hip and Knee Arthroplasty Using the Short Form-6D Utility Measure

Cited by 47 publications

References 22 publications

Trends and patient factors associated with technology-assisted total hip arthroplasty in the United States from 2005 to 2014

Trends and patient factors associated with technology-assisted total hip arthroplasty in the United States from 2005 to 2014

Straight stem and threaded cup total hip arthroplasty systems in patients under 60 years of age: outdated or still a benchmark? A report on a cohort of 75 patients after 28.8-30.2 years of follow-up

Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients

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