The Cost-Effectiveness of Surgical Treatment of Medial Unicompartmental Knee Osteoarthritis in Younger Patients by Joseph F. Konopka, Andreas H. Gomoll,

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Presentation transcript:

The Cost-Effectiveness of Surgical Treatment of Medial Unicompartmental Knee Osteoarthritis in Younger Patients by Joseph F. Konopka, Andreas H. Gomoll, Thomas S. Thornhill, Jeffrey N. Katz, and Elena Losina J Bone Joint Surg Am Volume 97(10):807-817 May 20, 2015 ©2015 by The Journal of Bone and Joint Surgery, Inc.

The structure of the Markov model for high tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA), and total knee arthroplasty (TKA). The structure of the Markov model for high tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA), and total knee arthroplasty (TKA). Diamonds represent transition states during which a surgical intervention occurs. Ovals represent transition states during which no surgical intervention occurs. Straight arrows indicate a transition to a different transition state, and curved arrows indicate staying in the same transition state. Two transition states are not depicted: permanently living with a suboptimal prosthesis and the absorbing death state. Joseph F. Konopka et al. J Bone Joint Surg Am 2015;97:807-817 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Two-way sensitivity analyses of the rates of conversion to total knee arthroplasty (TKA) for unicompartmental knee arthroplasty (UKA) versus high tibial osteotomy (HTO) (left panel) and the utility of conversion for UKA versus HTO (right panel). Two-way sensitivity analyses of the rates of conversion to total knee arthroplasty (TKA) for unicompartmental knee arthroplasty (UKA) versus high tibial osteotomy (HTO) (left panel) and the utility of conversion for UKA versus HTO (right panel). Cost-effectiveness was compared when the annual rates of conversion and annual utility derived from conversion were allowed to vary. The willingness-to-pay (WTP) threshold of $100,000 per quality-adjusted life-year (QALY) is depicted by a solid line, and the WTP threshold of $50,000 per QALY is depicted by the dashed line. The base case is indicated by the white square. Joseph F. Konopka et al. J Bone Joint Surg Am 2015;97:807-817 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Cost-effectiveness scatter plot of a Monte Carlo model of 10,000 theoretical patients, fifty to sixty years of age, undergoing each surgical strategy. Cost-effectiveness scatter plot of a Monte Carlo model of 10,000 theoretical patients, fifty to sixty years of age, undergoing each surgical strategy. Each outcome is represented by a dot colored to correspond with the primary surgery. The mean values for high tibial osteotomy (HTO), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA) are represented by the large diamond, square, and triangle, respectively. Joseph F. Konopka et al. J Bone Joint Surg Am 2015;97:807-817 ©2015 by The Journal of Bone and Joint Surgery, Inc.

Cost-effectiveness acceptability curve. Cost-effectiveness acceptability curve. This figure demonstrates the probability of each surgical option being the cost-effective strategy at a given willingness-to-pay threshold, utilizing a Monte Carlo simulation of 10,000 patients. HTO = high tibial osteotomy, TKA = total knee arthroplasty, and UKA = unicompartmental knee arthroplasty. Joseph F. Konopka et al. J Bone Joint Surg Am 2015;97:807-817 ©2015 by The Journal of Bone and Joint Surgery, Inc.