Cost-effectiveness of total hip and knee replacements: 4 key points

Practice Management

A new study published in BMC Musculoskeletal Disorders examines whether total hip and knee replacements are cost effective for patients with osteoarthritis.

 

The study authors examined 23 studies published from 2004 to 2016 examining the economic impact of total joint replacement surgery.

 

1. In one study comparing total knee replacement to no treatment over the patient's 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.

 

2. 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.

 

3. For total hip replacement patients, a study comparing surgery to nonoperative 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.

 

4. The total hip replacement literature included multiple studies that compared the lifetime cost-effectiveness of cemented, cementless and hybrid techniques. The hybrid techniques were found most cost effective for patients 60 years old and older.

 

"The review assessed the cost-effectiveness of surgical interventions for the management of knee and hip osteoarthritis and the results suggest that TKA and THA are cost-effective interventions particularly when compared to non-operative strategies and also when the operation is not delayed," concluded the study authors. However, they also called for additional studies to assess surgical modalities.

 

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