Cost-Effectiveness of Unicompartmental and Total Knee Arthroplasty in Elderly Low-Demand Patients: A Markov Decision Analysis

Background: Interest in unicompartmental knee arthroplasty has recently increased in the United States, making a firm understanding of the indications for this procedure important. The purpose of this study was to examine the cost-effectiveness of unicompartmental knee arthroplasty compared with tot...

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Published in:Journal of bone and joint surgery. American volume 2006-11, Vol.88 (11), p.2348-2355
Main Authors: Slover, James, Espehaug, Birgitte, Havelin, Leif Ivar, Engesaeter, Lars Birger, Furnes, Ove, Tomek, Ivan, Tosteson, Anna
Format: Article
Language:English
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Summary:Background: Interest in unicompartmental knee arthroplasty has recently increased in the United States, making a firm understanding of the indications for this procedure important. The purpose of this study was to examine the cost-effectiveness of unicompartmental knee arthroplasty compared with total knee arthroplasty in elderly low-demand patients. Methods: A Markov decision model was used to evaluate the cost-effectiveness of unicompartmental knee arthroplasty as compared with total knee arthroplasty in the elderly population. Transition probabilities were estimated from the Norwegian Arthroplasty Register and the arthroplasty literature, and costs were based on the average Medicare reimbursement for unicompartmental, tricompartmental, and revision knee arthroplasties. Outcomes were measured in quality-adjusted life-years. Results: Our model showed unicompartmental knee arthroplasty to be a cost-effective strategy for this population as long as the annual probability of revision is
ISSN:0021-9355
DOI:10.2106/JBJS.E.01033