(HealthDay)—For a 50-year-old working person, the total economic cost to society for treatment of severe knee osteoarthritis is considerably lower with total knee arthroplasty than with nonoperative treatment, according to a study published in the Jan. 15 issue of The Journal of Bone and Joint Surgery.
Hany Bedair, M.D., from Massachusetts General Hospital in Boston, and colleagues compared the overall average cost over 30 years of total knee arthroplasty and the average 30-year cost of nonoperative treatment for a fifty-year-old patient with end-stage osteoarthritis using a Markov state-transition decision model. Factors considered included earned income, lost wages, and direct medical costs for nonoperative treatment as well as revisions and complications for total knee arthroplasty.
The researchers found that across all plausible values for most input parameters assessed, early total knee arthroplasty was favored over nonoperative treatment. During the first 3.5 years, total knee arthroplasty was more expensive because of higher initial costs, but the cost benefit was $69,800 over 30 years (2012 U.S. dollars). The model only favored nonoperative treatment when lost wages were <17.7 equivalent work days per year for patients treated nonoperatively and when the rate of returning to work after total knee arthroplasty was <81 percent.
"The increasing financial restrictions on health care providers in the United States necessitate careful consideration of the economic impact of different treatment options from the societal perspective," the authors write.
One or more authors disclosed a financial tie to an entity in the biomedical arena.
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