Abstract | BACKGROUND: METHODS: A decision model was created for the treatment of end-stage unicompartmental knee arthritis. A literature review was used to identify possible outcomes and their probabilities following treatment with either unicompartmental or total knee arthroplasty. Each outcome was weighted for quality of life with use of a utility factor, and effectiveness was expressed in units of quality-adjusted life years. Gross costs were estimated from Medicare reimbursement data for the relevant Current Procedural Terminology and Diagnosis-Related Group codes. RESULTS: Sensitivity analysis demonstrated that the cost-effectiveness of unicompartmental knee arthroplasty is dependent on the assumption that its durability and functional outcomes approach those of total knee arthroplasty. Specifically, it is necessary for the survival of unicompartmental implants to be within three to four years of the assumed survival of total knee implants for unicompartmental arthroplasty to remain a cost-effective alternative. Under these assumptions, the use of unicompartmental arthroplasty is a cost-effective choice as it results in incremental gains in effectiveness at a cost of less than US dollars 50,000 (in 1998 United States dollars) per quality-adjusted life year gained. CONCLUSIONS: LEVEL OF EVIDENCE: Economic and decision analysis, Level II.
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Authors | Nelson F Soohoo, Husham Sharifi, Gerald Kominski, Jay R Lieberman |
Journal | The Journal of bone and joint surgery. American volume
(J Bone Joint Surg Am)
Vol. 88
Issue 9
Pg. 1975-82
(Sep 2006)
ISSN: 0021-9355 [Print] United States |
PMID | 16951114
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Arthroplasty, Replacement, Knee
(economics, methods)
- Cost-Benefit Analysis
- Decision Support Techniques
- Humans
- Multivariate Analysis
- Osteoarthritis, Knee
(economics, surgery)
- Quality of Life
- United States
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