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 journalArticlepeer-review

13 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)3412-3415
Number of pages4
JournalJournal of Arthroplasty
Issue number11
Publication statusPublished - 1 Nov 2018
Externally publishedYes


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

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this