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Costs of Nonoperative Procedures for Knee Osteoarthritis in the Year Prior to Primary Total Knee Arthroplasty

Journal of Bone and Joint Surgery, ISSN: 1535-1386, Vol: 104, Issue: 19, Page: 1697-1702
2022
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Metric Options:   Counts1 Year3 Year

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Type, cost of nonoperative treatment for late-stage knee OA varied prior to TKA

Published results showed the type and cost of nonoperative treatment had substantial variation among patients with late-stage knee osteoarthritis prior to total knee arthroplasty. “Intra-articular hyaluronic acid injections and physical therapy were the two most costly interventions within the 12 months prior to TKA,” Eric L. Smith, MD, told Healio. “We believe that these interventions do not add

Article Description

Background:The convergence of national priorities to reduce health-care costs and deliver high-value care warrants the need to examine health-care utilization. The objective of this study was to describe the costs associated with nonoperative procedures in the 1-year period leading up to primary total knee arthroplasty (TKA).Methods:An observational cohort study was conducted using the IBM Watson Health MarketScan databases. Patients with late-stage knee osteoarthritis (OA) who underwent unilateral, isolated primary TKA from January 1, 2018, to December 31, 2019, were included. The main outcome was the cost of knee OA-related payments for identified nonoperative procedures in the 1-year period before surgery. Nonoperative procedures examined were (1) physical therapy (PT); (2) bracing; (3) intra-articular injections: professional fee, hyaluronic acid (IA-HA), and corticosteroids (IA-CS); (4) medication: nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and acetaminophen; and (5) knee-specific imaging.Results:The study population included 24,492 TKA patients with a mean age of 60.4 ± 8.0 years. The average total cost of nonoperative procedures per patient was $1,355 ± $2,087. The most common nonoperative treatment prescribed was IA-CS (54.3%). The nonoperative procedure with the highest cost per patient was IA-HA ($1,019 ± $913 per patient). The total cost of nonoperative procedures was higher among female compared with male patients ($1,440 ± $2,159 versus $1,254 ± $1,992 per patient; p < 0.01). The highest costs were found for patients in the Northeast ($1,740 ± $2,437 per patient). A total of 14,346 (58.6%) and 7,831 (32.0%) of the patients had >1 and ≥3 nonoperative treatments, respectively.Conclusions:There is substantial variation in the type and the cost of nonoperative treatment for patients with late-stage OA. Future studies should investigate the effectiveness of nonoperative treatments at different stages of the disease.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. COPYRIGHT

Bibliographic Details

Nin, Darren Z; Chen, Ya-Wen; Talmo, Carl T; Hollenbeck, Brian L; Mattingly, David A; Niu, Ruijia; Chang, David C; Smith, Eric L

Ovid Technologies (Wolters Kluwer Health)

Medicine

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