Effect of Age on Cost-Effectiveness of Unicompartmental Knee Arthroplasty Compared with Total Knee Arthroplasty in the U.S.

Ghomrawi, Hassan; Eggman, Ashley A.; Pearle, Andrew D.

doi:10.2106/jbjs.n.00169

Cited by 72 publications

(44 citation statements)

References 32 publications

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“…Multiple studies have demonstrated that conclusions related to the cost-effectiveness of UKA, TKA and HTO are highly sensitive to annual revision rates [8,78–80]. For example, it has been demonstrated that UKA is cost-effective compared to TKA if the annual revision rate is <4.0 per year in 78 year old patients [78].…”

Section: Discussionmentioning

confidence: 99%

“…Many distinct advantages of UKA compared to total knee arthroplasty (TKA) have been reported including lower perioperative morbidity [2,3], lower risk for infection [4], less blood loss [5], accelerated recovery [6,7] and improved range of motion [2,7]. A recent cost-effectiveness study demonstrated that medial UKA is preferable to TKA with decreased lifetime costs and improved quality of life in patients over 65 years of age [8]. …”

Section: Introductionmentioning

confidence: 99%

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Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up

et al. 2017

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“…Cost-effective analysis calculated in orthopaedic literature has demonstrated the value provided to economies as a whole with timely, and age-specific therapy in joint replacement surgery. 3 Time to surgery also plays a role in providing value to this patient population. A study comparing cost-utility analysis for carpal tunnel release in the United States and Canada showed significant health-related quality of life improvements calculated to be $7,758/quality-adjusted life year greater in the U.S. population compared with Canada's due to shorter wait times.…”

Section: Restoration Of Form and Functionmentioning

confidence: 99%

Creating Value in Plastic Surgery

Jalalabadi

Izaddoost

Reece

2018

Seminars in Plastic Surgery

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Value is defined as the worth, utility, or importance something holds. It can be derived from a variety of goods and services and is relative to a given industry or population. This article will discuss elements of plastic surgery that hold value as to how it pertains to the key players in a medical transaction. It will also discuss strategies for identifying and generating value. Roles of the different members in a plastic surgery transaction were analyzed, specifically the patient, the surgeon, and the facility. Different factors that generated value for all parties were identified throughout the literature. Factors identified that created value included the following: the surgeon's knowledge, experience, and decision-making ability; and technical skill/speed, restoration of life, restoration of form and function, restoration of psychological deficit, instant surgical results, convenience of access, outcomes, cost accounting, research, compassion, and bedside manner. Plastic surgeons can gear their practice to provide the system and their patients with services that hold value. We present several factors that can generate value for the patient, surgeon, and hospital system.

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“…In view of excellent functional results, good long-term survivorship, and advantages in terms of cost efficiency, unicompartmental knee arthroplasty (UKA) can make a significant contribution to meet the rapidly growing demand for knee arthroplasty [1][2][3][4][5]. Since the aseptic loosening of the tibial component, misinterpretation of radiolucent lines and cementation errors remain major reasons for revision in UKA [6][7][8][9]; improvements of the interface between prosthesis, cement, and trabecular bone, as well as the optimization of minimally invasive surgical techniques, are of outstanding importance [10,11].…”

Section: Introductionmentioning

confidence: 99%

Influence of bone density on morphologic cement penetration in minimally invasive tibial unicompartmental knee arthroplasty: an in vitro cadaver study

et al. 2019

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Background: Unicompartmental knee arthroplasty is an established treatment option for anteromedial osteoarthritis. However, large registry studies report higher rates of aseptic loosening compared to total knee arthroplasty. The objective of this study was to assess the impact of bone density on morphological cement penetration. Moreover, an alternative regional bone density measuring technique was validated against the established bone mineral density assessment. Methods: Components were implanted on the medial side of 18 fresh-frozen cadaver knees using a minimally invasive approach. Bone density has been quantified prior to implantation using Hounsfield units and bone mineral density. Morphological cement penetration has been assessed in different areas and was correlated with local bone density. Findings: A highly significant correlation between Hounsfield units and trabecular bone mineral density was detected (r = 0.93; P < 0.0001), and local bone density was significantly increased in the anterior and posterior area (P = 0.0003). The mean cement penetration depth was 1.5 (SD 0.5 mm), and cement intrusion into trabecular bone was interrupted in 31.8% (SD 23.7%) of the bone-cement interface. Bone density was correlated significantly negative with penetration depth (r = − 0.31; P = 0.023) and positive with interruptions of horizontal interdigitating (r = + 0.33; P = 0.014). Cement penetration around the anchoring peg was not significantly correlated with bone density. Interpretation: Areas with high bone density were characterized by significantly lower penetration depths and significantly higher areas without cement penetration. Anchoring pegs facilitate cement intrusion mechanically. Regional quantification of bone density using Hounsfield units is a simple but valuable extension to the established determination of bone mineral density.

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Effect of Age on Cost-Effectiveness of Unicompartmental Knee Arthroplasty Compared with Total Knee Arthroplasty in the U.S.

Abstract: Unicompartmental knee arthroplasty is an economically attractive alternative in patients sixty-five years of age or older, and modest improvements in implant survivorship could make it a cost-effective alternative in younger patients.

Cited by 72 publications

References 32 publications

Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up

Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up

Creating Value in Plastic Surgery

Influence of bone density on morphologic cement penetration in minimally invasive tibial unicompartmental knee arthroplasty: an in vitro cadaver study

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