The Cost-Effectiveness of Total Knee & Hip Replacement
BioMed Central, a well-known scientific publisher out of the U.K., conducted a study to assess the existing evidence on the cost-effectiveness of surgery for the management of knee and hip osteoarthritis by systematically reviewing published economic evaluation studies.
The review was conducted for economic evaluation studies on total knee arthroplasty (TKA) and total hip arthroplasty (THA) that were published between the years of 2004-2016.
In a study comparing total knee replacement to no treatment over the patients’ lifetime found surgery was cost-effective; another comparing early and delayed knee replacements with and without an operative bridge in patients 60 years or older found surgery without delay was the most cost-effective strategy.
A common refrain Dr. Matsen Ko hears in clinic is “I wish I hadn’t waited so long!” Patients often are so pleased with their new joint that they wish they had not put off surgery for so long. They are back riding horses, caring for their grandchildren and hiking in the mountains without pain.
A further study compared two total knee replacement techniques and found newer implants were cost-effective if they could reduce failure rate by 50 percent. Finally, total knee replacements were found cost-effective across all risk groups and more cost-effective at high volume hospitals.
Dr. Matsen Ko notes that “The new implants have a longer life than the implants manufactured prior to 2000. We are optimistic that the current materials used will last well over 20 years prior to needing any revision surgery.”
For total hip replacement patients, a study comparing surgery to non-operative strategies found total hip arthroplasty the most cost-effective intervention. A further study found early hip surgery was the most cost-effective option for patients across all demographic groups.
Dr Matsen Ko’s commentary:
This is a nice review of the cost-effectiveness of total hip and knee replacement. Multiple studies show that, when indicated, both total hip and knee replacement without delay is the most cost-effective strategy. The studies also show a dramatic increase in quality of life after total joint replacement which is my goal for all of my patients.
Some of the studies focused on a younger working population with the goal of getting the patient over surgery and back to work, while minimizing down time. Other studies looked at the older, Medicare-aged population; and the findings held true for both.
It is important to take these results into consideration with the risks of surgery. We recommend a thorough pre-operative evaluation to optimize a patient’s medical health prior to proceeding with surgery so we can ensure the best possible results.
In summary, when medically indicated, proceeding with surgical management of hip and knee arthritis may be cost-effective and increase patients’ quality of life.
-Dr. Laura Matsen Ko
Joint Replacement Surgeon
Read the full study, here.
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