A Cost-Utility Analysis Comparing the Cost-Effectiveness of Simultaneous and Staged Bilateral Total Knee Arthroplasty

• DOI: 10.2106/jbjs.l.00373
• Publication Date: 2013-08-21T15:30:42Z
• Authors: Susan M. Odum; Jennifer L. Troyer; Michael P. Kelly; Russell D. Dedini; Kevin J. Bozic
• Keywords: Cost–utility analysis

The safety and efficacy of simultaneous or staged bilateral total knee arthroplasty have long been debated among orthopaedic surgeons. Advocates for posit that the benefits decreased costs recovery time, with no difference in functional outcomes, outweigh economic potential complications. purpose study was to conduct a cost-utility analysis comparing arthroplasty.A Markov model designed compare cost-effectiveness arthroplasty. Nationwide Inpatient Sample data sets from 2004 2007 were used identify 24,574 382,496 unilateral procedures. On basis codes International Classification Diseases, Ninth Revision, Clinical Modification, perioperative complications categorized as minor, major, mortality, respective probability values calculated. determine hospital conditional on procedure type Rehabilitation costs, anesthesia heath utilities estimated literature. To minimize selection bias, propensity score matching match groups comorbid conditions, socioeconomic variables, characteristics.Using matched sample, all complication rates higher group. mean cost (in 2012 U.S. dollars) $43,401 compared $72,233 quality-adjusted life years gained 9.31 9.29 these results, dominated lower better outcomes.On this analysis, is more cost-effective than arthroplasty, outcomes average patient. These can inform shared medical decision-making when indicated.