Patellar Resurfacing in Total Knee Arthroplasty: A Cost-Effectiveness Analysis

Colleen A. Weeks, Jacquelyn D. Marsh, Steven J. MacDonald, Stephen Graves, Edward M. Vasarhelyi

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: This study estimates the cost-effectiveness of patellar resurfacing in total knee arthroplasty (TKA). Methods: We conducted a cost-effectiveness analysis using a decision analytic model representing a hypothetical TKA cohort, with or without patellar resurfacing, using data from the 2014 Australian Registry. The model represents 3 possible postoperative health states: (1) well, (2) patellofemoral pain, or (3) serious adverse event (any event resulting in a revision). Our effectiveness outcome was the quality-adjusted life year, from published utility scores. We estimated cost-effectiveness from a Canadian public healthcare payer perspective. Costs and quality of life were valued in 2015 United States dollars and discounted annually at 5%. Results: Our results suggest that TKA with resurfacing is cost-effective compared to nonresurfacing. Unresurfacing the patellae resulted in higher costs ($13,296.63 vs $12,917.01) and lower quality-adjusted life year (5.37 vs 6.01) at 14 years. Sensitivity analysis suggests that if rates of secondary resurfacing are <0.5%, there was no cost difference. Conclusion: Over 14 years postoperative, patellar resurfacing appears to be cost-effective, due to higher revision rates for unresurfaced TKA. Although our results suggest resurfacing improves quality of life, our model is limited by the availability and validity of long-term utility outcomes reported for TKA. Our cost-effectiveness analysis showed superiority of the resurfacing compared to retention of the patella.

LanguageEnglish
Pages3412-3415
Number of pages4
JournalJournal of Arthroplasty
Volume33
Issue number11
DOIs
Publication statusPublished - 1 Nov 2018
Externally publishedYes

Keywords

  • cost-effectiveness
  • economic analysis
  • patellar resurfacing
  • revision total knee arthroplasty
  • total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Weeks, C. A., Marsh, J. D., MacDonald, S. J., Graves, S., & Vasarhelyi, E. M. (2018). Patellar Resurfacing in Total Knee Arthroplasty: A Cost-Effectiveness Analysis. Journal of Arthroplasty, 33(11), 3412-3415. https://doi.org/10.1016/j.arth.2018.07.001
Weeks, Colleen A. ; Marsh, Jacquelyn D. ; MacDonald, Steven J. ; Graves, Stephen ; Vasarhelyi, Edward M. / Patellar Resurfacing in Total Knee Arthroplasty : A Cost-Effectiveness Analysis. In: Journal of Arthroplasty. 2018 ; Vol. 33, No. 11. pp. 3412-3415.
@article{8e1d0a009832495aacc65850fc84ac68,
title = "Patellar Resurfacing in Total Knee Arthroplasty: A Cost-Effectiveness Analysis",
abstract = "Background: This study estimates the cost-effectiveness of patellar resurfacing in total knee arthroplasty (TKA). Methods: We conducted a cost-effectiveness analysis using a decision analytic model representing a hypothetical TKA cohort, with or without patellar resurfacing, using data from the 2014 Australian Registry. The model represents 3 possible postoperative health states: (1) well, (2) patellofemoral pain, or (3) serious adverse event (any event resulting in a revision). Our effectiveness outcome was the quality-adjusted life year, from published utility scores. We estimated cost-effectiveness from a Canadian public healthcare payer perspective. Costs and quality of life were valued in 2015 United States dollars and discounted annually at 5{\%}. Results: Our results suggest that TKA with resurfacing is cost-effective compared to nonresurfacing. Unresurfacing the patellae resulted in higher costs ($13,296.63 vs $12,917.01) and lower quality-adjusted life year (5.37 vs 6.01) at 14 years. Sensitivity analysis suggests that if rates of secondary resurfacing are <0.5{\%}, there was no cost difference. Conclusion: Over 14 years postoperative, patellar resurfacing appears to be cost-effective, due to higher revision rates for unresurfaced TKA. Although our results suggest resurfacing improves quality of life, our model is limited by the availability and validity of long-term utility outcomes reported for TKA. Our cost-effectiveness analysis showed superiority of the resurfacing compared to retention of the patella.",
keywords = "cost-effectiveness, economic analysis, patellar resurfacing, revision total knee arthroplasty, total knee arthroplasty",
author = "Weeks, {Colleen A.} and Marsh, {Jacquelyn D.} and MacDonald, {Steven J.} and Stephen Graves and Vasarhelyi, {Edward M.}",
year = "2018",
month = "11",
day = "1",
doi = "10.1016/j.arth.2018.07.001",
language = "English",
volume = "33",
pages = "3412--3415",
journal = "Journal of Arthroplasty",
issn = "0883-5403",
publisher = "Churchill Livingstone",
number = "11",

}

Weeks, CA, Marsh, JD, MacDonald, SJ, Graves, S & Vasarhelyi, EM 2018, 'Patellar Resurfacing in Total Knee Arthroplasty: A Cost-Effectiveness Analysis', Journal of Arthroplasty, vol. 33, no. 11, pp. 3412-3415. https://doi.org/10.1016/j.arth.2018.07.001

Patellar Resurfacing in Total Knee Arthroplasty : A Cost-Effectiveness Analysis. / Weeks, Colleen A.; Marsh, Jacquelyn D.; MacDonald, Steven J.; Graves, Stephen; Vasarhelyi, Edward M.

In: Journal of Arthroplasty, Vol. 33, No. 11, 01.11.2018, p. 3412-3415.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Patellar Resurfacing in Total Knee Arthroplasty

T2 - Journal of Arthroplasty

AU - Weeks, Colleen A.

AU - Marsh, Jacquelyn D.

AU - MacDonald, Steven J.

AU - Graves, Stephen

AU - Vasarhelyi, Edward M.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: This study estimates the cost-effectiveness of patellar resurfacing in total knee arthroplasty (TKA). Methods: We conducted a cost-effectiveness analysis using a decision analytic model representing a hypothetical TKA cohort, with or without patellar resurfacing, using data from the 2014 Australian Registry. The model represents 3 possible postoperative health states: (1) well, (2) patellofemoral pain, or (3) serious adverse event (any event resulting in a revision). Our effectiveness outcome was the quality-adjusted life year, from published utility scores. We estimated cost-effectiveness from a Canadian public healthcare payer perspective. Costs and quality of life were valued in 2015 United States dollars and discounted annually at 5%. Results: Our results suggest that TKA with resurfacing is cost-effective compared to nonresurfacing. Unresurfacing the patellae resulted in higher costs ($13,296.63 vs $12,917.01) and lower quality-adjusted life year (5.37 vs 6.01) at 14 years. Sensitivity analysis suggests that if rates of secondary resurfacing are <0.5%, there was no cost difference. Conclusion: Over 14 years postoperative, patellar resurfacing appears to be cost-effective, due to higher revision rates for unresurfaced TKA. Although our results suggest resurfacing improves quality of life, our model is limited by the availability and validity of long-term utility outcomes reported for TKA. Our cost-effectiveness analysis showed superiority of the resurfacing compared to retention of the patella.

AB - Background: This study estimates the cost-effectiveness of patellar resurfacing in total knee arthroplasty (TKA). Methods: We conducted a cost-effectiveness analysis using a decision analytic model representing a hypothetical TKA cohort, with or without patellar resurfacing, using data from the 2014 Australian Registry. The model represents 3 possible postoperative health states: (1) well, (2) patellofemoral pain, or (3) serious adverse event (any event resulting in a revision). Our effectiveness outcome was the quality-adjusted life year, from published utility scores. We estimated cost-effectiveness from a Canadian public healthcare payer perspective. Costs and quality of life were valued in 2015 United States dollars and discounted annually at 5%. Results: Our results suggest that TKA with resurfacing is cost-effective compared to nonresurfacing. Unresurfacing the patellae resulted in higher costs ($13,296.63 vs $12,917.01) and lower quality-adjusted life year (5.37 vs 6.01) at 14 years. Sensitivity analysis suggests that if rates of secondary resurfacing are <0.5%, there was no cost difference. Conclusion: Over 14 years postoperative, patellar resurfacing appears to be cost-effective, due to higher revision rates for unresurfaced TKA. Although our results suggest resurfacing improves quality of life, our model is limited by the availability and validity of long-term utility outcomes reported for TKA. Our cost-effectiveness analysis showed superiority of the resurfacing compared to retention of the patella.

KW - cost-effectiveness

KW - economic analysis

KW - patellar resurfacing

KW - revision total knee arthroplasty

KW - total knee arthroplasty

UR - http://www.scopus.com/inward/record.url?scp=85051532108&partnerID=8YFLogxK

U2 - 10.1016/j.arth.2018.07.001

DO - 10.1016/j.arth.2018.07.001

M3 - Article

VL - 33

SP - 3412

EP - 3415

JO - Journal of Arthroplasty

JF - Journal of Arthroplasty

SN - 0883-5403

IS - 11

ER -